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Osteoporosis is under-diagnosed and untreated in older men, study finds

Researchers say more older consumers should undergo arthritis screenings

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To help combat age-related bone mass loss, many older consumers have adopted habits like taking supplements or exercising. However, a new study conducted by researchers from the American College of Rheumatology found that osteoporosis remains a risk despite these efforts. 

According to their findings, the condition -- which affects older women in large numbers -- often goes undetected in older men. Their work revealed that many older men may not receive the proper diagnosis or treatment, even after undergoing injuries that tend to lead to osteoporosis. 

“Men are typically not part of routinely recommended screening...and so they are both underdiagnosed and undertreated,” said researcher Dr. Jeffrey Curtis. “While many comorbidities (i.e cardiovascular disease) are commonly recognized and treated in men, sometimes even more than women, osteoporosis is not one of them. Even post-fracture for major fractures like a hip, rates of treatment are disappointingly low, leaving men at risk for another fracture.” 

Why do these disparities exist?

To understand why older men are often neglected when it comes to testing for osteoporosis, the researchers analyzed Medicare data from nearly 10,000 people from 2010 through 2014. They were primarily interested in looking at the health care treatment for those who had experienced a serious fracture during that time frame. 

The researchers learned that the overwhelming majority of patients were not treated -- or ever even tested -- for osteoporosis following their injuries. They explained that a bone mineral density test is the most common way to detect osteoporosis, and more than 90 percent of the participants never received this exam. 

Just under three percent of the patients were given a bone density test; however, they never received any subsequent treatment for the condition. Ultimately, just over two percent of the study participants were given the proper test, diagnosis, and treatment for osteoporosis. 

According to the researchers, the primary issue with diagnosing and treating osteoporosis in older men comes down to unclear guidelines. They explained that national guidelines recommend that all women over the age of 65 are tested for osteoporosis, but men are excluded from these exams unless they have other conditions that could increase their risk. This is concerning for several reasons, not the least of which is because more than 62 percent of the study participants had prior musculoskeletal issues. 

Moving forward, the researchers hope that these testing and treatment guidelines are made clearer to ensure that older men are receiving the proper care. 

“This is a need for consistent osteoporosis screening recommendations in men,” Dr. Curtis said. “Incorporation of these recommendations in quality-of-care measures for osteoporosis management and post-fracture care are warranted to improve health outcomes in this population. 

“As for the next steps for research in this area, there is a need for better characterization of high-risk patients including existing comorbidities that may have shared etiology or risk factors that may enable earlier identification or treatment,” he said. 

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