title: Time to Osteoporosis and Major Fracture in Older Men: The MrOS Study.
abstract: For older men who undergo bone mineral density (BMD) testing, the optimal osteoporosis screening schedule is unknown. Time-to-disease estimates are necessary to inform screening intervals.
  
  
  
  A prospective cohort study of 5,415 community-dwelling men aged ≥65 years without hip or clinical vertebral fracture or antifracture treatment at baseline was conducted. Participants had concurrent BMD and fracture follow-up between 2000 and 2009, and additional fracture follow-up through 2014. Data were analyzed in 2015. Time to incident osteoporosis (lowest T-score ≤ -2.50) for men without baseline osteoporosis, and time to hip or clinical vertebral fracture or major osteoporotic fracture for men without or with baseline osteoporosis, were estimated.
  
  
  
  Nine men (0.2%) with BMD T-scores >-1.50 at baseline developed osteoporosis during follow-up. The adjusted estimated time for 10% to develop osteoporosis was 8.5 (95% CI=6.7, 10.9) years for those with moderate osteopenia (lowest T-score, -1.50 to -1.99) and 2.7 (95% CI=2.1, 3.4) years for those with advanced osteopenia (lowest T-score, -2.00 to -2.49) at baseline. The adjusted times for 3% to develop a first hip or clinical vertebral fracture ranged from 7.1 (95% CI=6.0, 8.3) years in men with baseline T-scores > -1.50 to 1.7 (95% CI=1.0, 3.1) years in men with baseline osteoporosis.
  
  
  
  Men aged 65 years and older with femoral neck, total hip, and lumbar spine BMD T-scores >-1.50 on a first BMD test were very unlikely to develop osteoporosis during follow-up. Additional BMD testing may be most informative in older men with T-scores ≤-1.50.
authors.affiliation: Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina. Electronic address: margaret_gourlay@med.unc.edu.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Gourlay
authors.affiliation: Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Overman
authors.affiliation: Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Fine
authors.affiliation: Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Filteau
authors.affiliation: Research Institute, California Pacific Medical Center, San Francisco, California.
authors.forename: Peggy M
authors.initials: PM
authors.lastname: Cawthon
authors.affiliation: Department of Rheumatology, Park Nicollet Health Services, Minneapolis, Minnesota; Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota.
authors.forename: John T
authors.initials: JT
authors.lastname: Schousboe
authors.affiliation: Bone and Mineral Unit, Oregon Health and Science University, Portland, Oregon.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Orwoll
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Wilt
authors.affiliation: Garvan Institute of Medical Research, UNSW School of Public Health and Community Medicine, New South Wales, Australia; Centre for Health Technologies, University of Technology, Sydney, Australia.
authors.forename: Tuan V
authors.initials: TV
authors.lastname: Nguyen
authors.affiliation: Departments of Medicine and Division of Rheumatology, Center for Musculoskeletal Health, UC Davis Health System, Sacramento, California.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Lane
authors.affiliation: INSERM UMR 1033, University of Lyon, Lyon, France.
authors.forename: Pawel
authors.initials: P
authors.lastname: Szulc
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Brent C
authors.initials: BC
authors.lastname: Taylor
authors.affiliation: Department of Medicine, Columbia University, New York, New York.
authors.forename: Thuy-Tien
authors.initials: TT
authors.lastname: Dam
authors.affiliation: Bone and Mineral Unit, Oregon Health and Science University, Portland, Oregon; School of Public Health, Oregon Health and Science University, Portland, Oregon.
authors.forename: Carrie M
authors.initials: CM
authors.lastname: Nielson
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota; Geriatric Research Education and Clinical Center, Minneapolis VA Health Care System, Minneapolis, Minnesota.
authors.forename: Howard A
authors.initials: HA
authors.lastname: Fink
authors.affiliation: School of Public Health, Oregon Health and Science University, Portland, Oregon.
authors.forename: Jodi A
authors.initials: JA
authors.lastname: Lapidus
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California; Department of Medicine, University of California, San Diego, La Jolla, California.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Kado
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Diem
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, Minnesota; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
mesh_terms: D000368:Aged; D015519:Bone Density / Q000502:physiology; D006801:Humans; D008297:Male; D015233:Models, Statistical; D010024:Osteoporosis / Q000150:complications* / Q000175:diagnosis; D058866:Osteoporotic Fractures / Q000209:etiology / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
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