title: Estimated prevalence and patterns of presumed osteoporosis among older Americans based on Medicare data.
abstract: BACKGROUND
  Estimates of osteoporosis (OP) prevalence based on bone mineral density testing and fracture occurrence may be imprecise for small demographic groups. Medicare data are a useful supplemental source of information on OP.
  
  
  METHODS
  We studied people ages > or = 65 years covered by Medicare 2005. Cases of presumed OP were beneficiaries with physician services or inpatient claims for OP or for an associated fracture (hip, distal forearm, spine) in 1999-2005.
  
  
  RESULTS
  Among 911,327 beneficiaries with 6 or 7 years of Medicare coverage, the overall prevalence of OP and associated fractures was 29.7%. Prevalence was four times higher for women than men, increased with age, and was two times higher for whites, Hispanic Americans, and Asian Americans than African Americans. Among people with OP-associated fracture claims, the proportion with an OP diagnosis was 49.7% overall (women, 57.1%; men, 21.9%) and was lower for men than women and for African Americans than other ethnic groups.
  
  
  CONCLUSIONS
  The low proportion of beneficiaries who had an OP-associated fracture and also had an OP diagnosis, particularly among men and African American women, suggests suboptimal recognition and management of OP. Study limitations included lack of validation of our definition of OP and potential misclassification of race/ethnicity.
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA. editha@uab.edu
authors.forename: H
authors.initials: H
authors.lastname: Cheng
authors.forename: L C
authors.initials: LC
authors.lastname: Gary
authors.forename: J R
authors.initials: JR
authors.lastname: Curtis
authors.forename: K G
authors.initials: KG
authors.lastname: Saag
authors.forename: M L
authors.initials: ML
authors.lastname: Kilgore
authors.forename: M A
authors.initials: MA
authors.lastname: Morrisey
authors.forename: R
authors.initials: R
authors.lastname: Matthews
authors.forename: W
authors.initials: W
authors.lastname: Smith
authors.forename: H
authors.initials: H
authors.lastname: Yun
authors.forename: E
authors.initials: E
authors.lastname: Delzell
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology; D005260:Female; D050723:Fractures, Bone / Q000191:economics / Q000453:epidemiology*; D006801:Humans; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D010024:Osteoporosis / Q000191:economics / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology