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Time to Osteoporosis and Major Fracture in Older Men: The MrOS Study

Abstract

INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Type Journal
ISBN 1873-2607 (Electronic) 0749-3797 (Linking)
Authors Gourlay, M. L.; Overman, R. A.; Fine, J. P.; Filteau, G.; Cawthon, P. M.; Schousboe, J. T.; Orwoll, E. S.; Wilt, T. J.; Nguyen, T. V.; Lane, N. E.; Szulc, P.; Taylor, B. C.; Dam, T. T.; Nielson, C. M.; Cauley, J. A.; Barrett-Connor, E.; Fink, H. A.; Lapidus, J. A.; Kado, D. M.; Diem, S. J.; Ensrud, K. E.; Osteoporotic Fractures in Men Research, Group;
Publisher Name AM J PREV MED
Published Date 2016-06-01 00:00:00
Published Volume 50
Published Issue 6
Published Pages 727-36
URL http://www.ncbi.nlm.nih.gov/pubmed/26821835
Status Published In-print
OpenAccess Link https://publications.gimr.garvan.org.au/download.php?13555_13573/2016-Gourlay-Am J Prev Med.pdf