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 S. Orwoll, Timothy J. Wilt, Tuan V. Nguyen, Nancy E. Lane, Pawel Szulc, Brent C. Taylor, Thuy Tien Dam, Carrie M. Nielson, Jane A. Cauley, Elizabeth Barrett-Connor, Howard A. Fink, Jodi A. Lapidus, Deborah M. Kado, Susan J. DiemKristine E. Ensrud

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

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)
Pages (from-to)727-736
Number of pages10
JournalAmerican journal of preventive medicine
Volume50
Issue number6
DOIs
StatePublished - Jun 1 2016

Bibliographical note

Funding Information:
The project described was funded by grant number R01 AG046294 (Gourlay) and grant number K23AG040168 (Dam) from the National Institute on Aging, grant number UL1TR001111 from the National Center for Advancing Translational Sciences, and grant number K24 AR048841 (Lane) from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Wilt's effort was supported in part by the Department of Veterans Affairs (VA) Under Secretary's Award for Health Services Research and the Minneapolis VA High Value Care Initiative. The work of Drs. Taylor, Fink and Ensrud was supported in part with resources and use of facilities at the Minneapolis VA Medical Center. The Osteoporotic Fractures in Men Study is supported by NIH funding. The following institutes provide support: the National Institute on Aging, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Center for Advancing Translational Sciences, and NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128. The content is solely the responsibility of the authors and does not necessarily reflect the official views of the funding agencies. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or in the decision to submit the manuscript for publication.

Funding Information:
The project described was funded by grant number R01 AG046294 (Gourlay) and grant number K23AG040168 (Dam) from the National Institute on Aging, grant number UL1TR001111 from the National Center for Advancing Translational Sciences, and grant number K24 AR048841 (Lane) from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Wilt’s effort was supported in part by the Department of Veterans Affairs (VA) Under Secretary’s Award for Health Services Research and the Minneapolis VA High Value Care Initiative. The work of Drs. Taylor, Fink and Ensrud was supported in part with resources and use of facilities at the Minneapolis VA Medical Center. The Osteoporotic Fractures in Men Study is supported by NIH funding. The following institutes provide support: the National Institute on Aging, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Center for Advancing Translational Sciences, and NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128. The content is solely the responsibility of the authors and does not necessarily reflect the official views of the funding agencies. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or in the decision to submit the manuscript for publication.

Funding Information:
We thank John Preisser, PhD, of the University of North Carolina at Chapel Hill Department of Biostatistics for providing statistical code that was adapted for use in the current project; Dr. Preisser received funding from grant number K23RR024685 for this work.

Funding Information:
Dr. Cawthon reports research grants from GSK, IMS Health, and Merck and consulting for Eli Lilly and KineMed. Dr. Orwoll has received research and consulting support from Merck, Eli Lilly, and Amgen. Dr. Cauley has received consultant support from Merck. Dr. Ensrud serves as a consultant on a Data Monitoring Committee for Merck Sharpe & Dohme. Dr. Kado has consultant support from Kalytera Therapeutics, Takeda Pharmaceuticals, and Amgen. No other financial disclosures were reported by the authors of this paper.

Publisher Copyright:
© 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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