Factors associated with diagnosis and treatment of osteoporosis in older adults.
Osteoporosis is often undiagnosed and untreated. We surveyed 1,830 adults and identified factors associated with osteoporosis diagnosis and treatment. Individuals with several risk factors, including older age, were not more likely to be diagnosed or treated. Measures should be taken to improve osteoporosis identification and treatment in high-risk patients.


BACKGROUND
We aimed to identify patient characteristics associated with osteoporosis diagnosis and treatment.


METHODS
Survey was mailed to 1,830 women and men > or =60 years old in Pennsylvania. Multivariable logistic regression analyses were performed to determine odds ratios for osteoporosis diagnosis and treatment for individuals with established osteoporosis risk factors.


RESULTS
Surveys were completed by 1,268 adults (69.3%). Osteoporosis diagnosis was more commonly reported by participants with risk factors of female sex (OR, 3.60; 95% CI 2.31-5.61), prolonged oral steroid use (OR, 3.76, 95% CI 2.06-6.84), low-trauma fracture (OR, 2.14, 95% CI 1.44-3.17), height loss (OR, 1.83, 95% CI 1.28-2.64), and lower weight (OR, 1.35 per 11.4 kg decrease in weight; 95% CI, 1.16-1.56). Age and family history of osteoporosis were not predictive of osteoporosis diagnosis, when adjusting for other risk factors. Osteoporosis treatment was more commonly reported by participants with risk factors of female sex (OR, 5.19; 95% CI, 3.31-8.13), family history (OR, 2.18; 95% CI, 1.55-3.06), height loss (OR, 1.79; 95% CI 1.29-2.49), low-trauma fracture (OR, 1.66; 95% CI, 1.14-2.42), and lower weight (OR, 1.45 per 11.4 kg decrease in weight; 95% CI, 1.27-1.67). Osteoporosis treatment was not significantly associated with age or prolonged oral steroid use.


CONCLUSIONS
Individuals with several established osteoporosis risk factors are more likely to be underdiagnosed or undertreated.
Nayak
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School of Medicine, Department of Medicine, Division of General Internal Medicine, Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh, Pittsburgh, PA, USA. nayaks@upmc.edu
Roberts
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MS
Greenspan
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D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004812:Epidemiologic Methods; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D018579:Patient Selection; D012737:Sex Factors
D050071:Bone Density Conservation Agents; D005938:Glucocorticoids