title: Performance of risk assessment tools for predicting osteoporosis in south Indian rural elderly men.
abstract: Osteoporosis in elderly men is an under-recognized problem. In the current study, we intend to look at the performance of two risk assessment tools [OSTA and MORES] for the diagnosis of osteoporosis. Osteoporosis was seen in 1/4th of elderly men at spine and 1/6th of them at femoral neck. Both risk assessment tools were found to have good sensitivity in predicting osteoporosis at spine and femoral neck with good area under curve (AUC).
  
  
  OBJECTIVE
  This study attempts to look at the performance of osteoporosis self-assessment tool for Asians (OSTA) and male osteoporosis risk estimation score (MORES) for predicting osteoporosis in south Indian rural elderly men.
  
  
  METHODS
  Five hundred and twelve men above 65 years of age from a south Indian rural community were recruited by cluster random sampling. All subjects underwent detailed clinical, anthropometric, and bone mineral density measurement at lumbar spine and femoral neck using dual-energy X-ray absorptiometry scan. A T score ≤ - 2.5 was diagnostic of osteoporosis. Scores for OSTA and MORES were calculated at various cut offs, and their sensitivities and specificities for predicting osteoporosis were derived.
  
  
  RESULTS
  The prevalence of osteoporosis was found to be 16% at femoral neck and 23% at spine. OSTA with a cut-off value of ≤2 predicted osteoporosis with a sensitivity and specificity at lumbar spine of 94 and 17% and at femoral neck of 99 and 18%. The area under ROC curve for OSTA index for spine was 0.716 and for femoral neck was 0.778. MORES with a cut-off value of ≥6 predicted osteoporosis at spine with a sensitivity of 98% and specificity of 15%, and at femoral neck, they were 98 and 13%, respectively. The area under ROC curve for MORES for spine was 0.855 and for femoral neck was 0.760.
  
  
  CONCLUSIONS
  OSTA and MORES were found to be useful screening tools for predicting osteoporosis in Indian elderly men. These tools are simple, easy to perform, and cost effective in the context of rural Indian setting.
authors.affiliation: Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Satyaraddi
authors.affiliation: Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
authors.forename: Sahana
authors.initials: S
authors.lastname: Shetty
authors.affiliation: Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
authors.forename: Nitin
authors.initials: N
authors.lastname: Kapoor
authors.affiliation: Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
authors.forename: Kripa Elizabeth
authors.initials: KE
authors.lastname: Cherian
authors.affiliation: Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
authors.forename: Dukhabandhu
authors.initials: D
authors.lastname: Naik
authors.affiliation: Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
authors.forename: Nihal
authors.initials: N
authors.lastname: Thomas
authors.affiliation: Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, Tamil Nadu, 632004, India. thomasvpaul@yahoo.com.
authors.forename: Thomas Vizhalil
authors.initials: TV
authors.lastname: Paul
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000368:Aged; D019540:Area Under Curve; D015519:Bone Density; D005272:Femur Neck / Q000000981:diagnostic imaging; D006801:Humans; D007194:India; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis*; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012424:Rural Population; D012680:Sensitivity and Specificity
keywords: Mores; OSTA; Osteoporosis in men; Screening tool, India