Ultrasonometric profiling of incidence and risk of osteoporosis in rural women.
BACKGROUND
It is estimated that over 200 million people worldwide have osteoporosis. The prevalence of osteoporosis is continuing to escalate with the increasingly aging population. The major complication of osteoporosis is an increase in fragility fractures leading to morbidity, mortality, and decreased quality of life. This investigation profiled the incidence and risk of osteoporosis in adult women from a rural setting using ultrasonic bone scanning technology.


METHODS
Between 2001 and 2005, adult female subjects (n = 323) in the age range of 40-87 were drawn from an independent, community dwelling, convenience sample. Bone mineral density T-scores were evaluated using heel ultrasonometry. Demographic and risk factor data, Merck Osteoporosis Evaluation SCORE questionnaire data, and the Osteoporosis Risk Assessment questionnaire data were analyzed.


RESULTS
Results of these scans indicate that 25% of the total population had a T-score < or = -1.0, implying a 1.5- to 2.0-fold increase in risk ratio of hip or spinal fracture for each standard deviational decrease. Age at menopause and weight had a positive correlation with T-scores. While the overall scores on the Merck SCORE questionnaire were inversely correlated to T-scores, no significant correlation was found between the Osteoporosis Risk Assessment questionnaire and T-score data. Additionally, women who had taken estrogen had significantly higher T-scores (p = 0.038) than those who had not.


CONCLUSIONS
That approximately 25% of this sample has low bone mass or osteoporosis underscores the importance of early screening in order to develop preventative awareness and provide education on bone health management. This finding has particularly important ramifications, since the sample was rural women, who typically have limited access to diagnostic bone density procedures.
Gueldner
Sarah H
SH
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA. shg13@case.edu
Britton
Geraldine R
GR
Madhavan
Guruprasad
G
Pierce
Carolyn S
CS
Grabo
Theresa N
TN
Penrod
Janice
J
Stucke
Sheri A
SA
Liu
Chin-Fang
CF
D015502:Absorptiometry, Photon / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D018570:Risk Assessment / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000458:organization & administration; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*; D016387:Women's Health; D014932:Women's Health Services / Q000458:organization & administration