Osteoporosis in older men severely underestimated

Despite a high prevalence of osteoporosis in elderly Australian men, awareness, diagnosis and treatment of the condition remain low, according to a study published in the Medical Journal of Australia.

Ms Kerrin Bleicher, a physiotherapist and PhD student at the University of Sydney and co-authors, conducted a study to determine the proportion of older Australian men who meet the Pharmaceutical Benefits Scheme (PBS) criteria for osteoporosis treatment and are receiving effective treatment.

Of the 1,705 men aged over 70 years who participated in the study, 25% met one or more of the PBS criteria for osteoporosis treatment. A total 90% of the men who met the PBS criteria were unaware they had osteoporosis.

Ms Bleicher said that this lack of awareness may have resulted in substantial underestimation of osteoporosis prevalence in men in a recent report by the Australian Institute of Health and Welfare that relied on self-report of osteoporosis.

“Identifying men who will benefit from osteoporosis treatment and increasing the proportion of eligible men receiving appropriate treatment is a public health issue,” Ms Bleicher said.

“Both non-pharmacological treatments and pharmacological treatments need to be implemented to reduce fracture rates.”

Women misjudge fracture risk

Only one in three Australian women diagnosed with osteoporosis are aware they are at higher risk of sustaining debilitating bone fractures, according to an international study published with input from University of Sydney researchers.

The GLOW study, coordinated by the University of Massachusetts Medical School, involved more than 60,000 postmenopausal women in 10 countries including Australia, and was published in the March Osteoporosis International journal.

The study found only 43% of postmenopausal women diagnosed with osteoporosis, a condition putting them at high risk for fractures, thought their risk of a fracture was higher than other women their age.

Of the 2,904 Sydney postmenopausal women enrolled in the GLOW study, only 34% with two or more major risk factors perceived themselves to be at higher risk of a fracture than their peers.

Out of this group, 21% reported an osteoporosis diagnosis, 25% had sustained a previous fracture and a concerning 38% had reported recent falls. A total of 18% recorded low weight and 18% reported at least one of their parents had sustained a hip fracture.

Professor Philip Sambrook from the University’s Department of Rheumatology said this failure by postmenopausal women to appreciate their personal risk of fracture presented a barrier to them receiving appropriate management of their condition and safe and effective treatments. 

According to Professor Sambrook, improved education of both physicians and postmenopausal women about osteoporosis risk factors is urgently needed.

“Since many fractures can be prevented by appropriate treatment, it is important that elevated risk be recognised,” Professor Sambrook said.

“We hope the insight we obtain from GLOW will help physicians and patients work together to both identify those at risk for fracture and to enhance understanding of the meaning of that risk.

“Education is critical if we are to reduce the burden of fractures worldwide.”