Osteoporosis is a progressive and systemic skeletal disease characterised by low bone mass and bone mineral density. Loss of bone mineral density usually starts around the age of 30-40 years in both men and women; by the time you cross the age of 60 years, the risks of developing osteoporosis become higher.
This clearly indicates that ageing is a major risk factor for osteoporosis, a highly debilitating disease where a single fall can result in a fracture and affect your health and quality of life.
Gender disparities in osteoporosis
Research also shows that there are key gender disparities in osteoporosis which affect the way this disease is screened, diagnosed and treated all over the world. A study published in the Journal of Clinical Medicine Research in 2017 says that while an estimated 200 million people suffer from osteoporosis globally, the disease is four times more common in women than in men.
However, evidence suggests that men tend to have more severe osteoporosis-related complications.
A study in Drug Design, Development and Therapy in 2013 suggests that awareness about male osteoporosis is lacking in large parts of the world. Since survival rates are considerably lower for men who experience a fracture, this gap in knowledge needs correction.
This study, in fact, mentions that the health effects of osteoporosis-related fractures in men are similar to that of myocardial infarction (heart attack) and exceed those of lung and prostate cancers.
Another study in the Indian Journal of Endocrinology and Metabolism in 2018 indicates that Indian men above 50 years of age tend to have a low bone mass score compared to women, which increases their susceptibility to osteoporosis.
In fact, in India, both ageing men and postmenopausal women should be screened for osteoporosis and must adopt measures to prevent the disease altogether.
Osteoporosis underdiagnosed and undertreated in men
A new study presented at the American College of Rheumatology’s annual convergence meeting not only reaffirms these gender disparities in osteoporosis but also posits that osteoporosis in men is consistently underdiagnosed and undertreated, even when they experience a fracture.
The study, conducted by researchers based at the University of Alabama at Birmingham’s Division of Clinical Immunology and Rheumatology, included 9,876 male beneficiaries of Medicare fee-for-service between 2010 and 2014 who had experienced fractures.
Of these participants, 61 percent were 75 years old or above and 90.3 percent were white. The researchers found that less than six percent of the participants had undergone bone mineral density testing in the two years preceding their fracture.
This was despite the fact that 62.8 percent had a history of musculoskeletal pain and 48.5 percent had a history of opioid use. The study also found that the most commonly-observed fracture sites for the participants were spine (31 percent), hip (27.9 percent) and ankle (9.8 percent).
Of all the patients, 92.8 percent did not even have a claim for diagnosis or treatment of osteoporosis at the time of their fracture. Only 2.8 percent of the patients were diagnosed with osteoporosis before the fracture but did not receive any treatment. On the other hand, 2.3 percent of the patients were treated for osteoporosis but remained undiagnosed and only 2.1 percent of all the patients received both proper diagnosis and care.
These immense discrepancies were observed in patient care despite the fact that bone mineral density screenings of patients between 2012 and 2014 showed a pronounced decline in bone health.
The study, therefore, highlights clearly that there’s a high level of underdiagnosis and undertreatment of osteoporosis in older male populations who experience fractures. Better awareness and use of screening tools is recommended by the researchers so that high-risk male osteoporosis patients are recognised early and provided with proper osteoporosis therapies.
For more information, read our article on Osteoporosis.
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