20 million elderly eligible for osteoporosis therapy in the USA
MedWire News: Almost 20% of elderly men and 30% of elderly women in the USA have a fracture risk that warrants pharmacological therapy, suggests an analysis of NHANES data.
In 2008, the National Osteoporosis Foundation (NOF) issued guidance on eligibility for osteoporosis treatment. Using NHANES (National Health and Nutrition Examination Survey) data collected between 1988 and 1994, Bess Dawson-Hughes (Tufts University, Boston, Massachusetts, USA) and colleagues estimated the effect of NOF guidance on patterns of osteoporosis treatment.
However, secular changes in the management of femoral neck bone mineral density, as well as changes to the inclusion and prevalence in the guidelines of certain risk factors used for fracture prediction, have occurred since 1994, remark the researchers.
Since these changes could significantly alter their results, the researchers re-worked their calculations based on data from NHANES 2005-2008 from 3608 individuals aged over 50 years, and the new NOF guidance based on risk assessment using the Fracture Risk Assessment Tool (FRAX).
As reported in the journal Osteoporosis International, the prevalence of osteoporosis at the femoral neck ranged from 6.0% in non-Hispanic Black women, to 12.6% in Mexican-American women. Similarly, Mexican-American women had higher rates of spinal osteoporosis (24.4%) than non-Hispanic Black women (5.3%), or non-Hispanic White women (10.9%).
Although rates of osteoporosis differed, treatment eligibility was similar in Mexican-American women and non-Hispanic White women, at 32.0 and 32.8%, respectively, and was 11.0% in non-Hispanic Black women. Men had more varied results according to race, with 21.1% of non-Hispanic White men, 12.6% of Mexican Americans, and 3.0% of non-Hispanic Black men eligible for treatment. This equates to 20 million older US adults being eligible for osteoporosis treatment, the authors note.
Commenting on the findings, Dawson-Hughes and co-workers say: "While it is the prevailing view that osteoporosis is most common in non-Hispanic Whites, intermediate in Mexican Americans, and least common in non-Hispanic Blacks, we note herein that the prevalence of lumbar spine osteoporosis in Mexican-American men and women was more than double that in non-Hispanic White men and women."
The team adds that "recognition of the numbers eligible for consideration for treatment helps identify a goal by which to assess the impact or success of prevention and treatment efforts in the USA."
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By Philip Ford