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

Margaret L. Gourlay, Robert A. Overman, Jason P. Fine, Guillaume Filteau, Peggy M. Cawthon, John T. Schousboe, Eric Orwoll, Timothy J. Wilt, Tuan V. Nguyen, Nancy E. Lane, Pawel Szulc, Brent C. Taylor, Thuy Tien Dam, Carrie Nielson, Jane A. Cauley, Elizabeth Barrett-Connor, Howard A. Fink, Jodi Lapidus, Deborah M. Kado, Susan J. DiemKristine E. Ensrud

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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.

Original languageEnglish (US)
JournalAmerican Journal of Preventive Medicine
DOIs
StateAccepted/In press - 2016

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ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Gourlay, M. L., Overman, R. A., Fine, J. P., Filteau, G., Cawthon, P. M., Schousboe, J. T., Orwoll, E., Wilt, T. J., Nguyen, T. V., Lane, N. E., Szulc, P., Taylor, B. C., Dam, T. T., Nielson, C., Cauley, J. A., Barrett-Connor, E., Fink, H. A., Lapidus, J., Kado, D. M., ... Ensrud, K. E. (Accepted/In press). Time to Osteoporosis and Major Fracture in Older Men. The MrOS Study. American Journal of Preventive Medicine. https://doi.org/10.1016/j.amepre.2015.11.015