Senior men need bone density tests


Exercise can help prevent osteoporosis for older adults. By Jasminee Sahoye
Exercise can help prevent osteoporosis for older adults.
By Jasminee Sahoye

Osteoporosis is often associated with women but more men over 65 have been diagnosed.

For women screening is now routine but when it comes to men, most are never screened and therefore suffer the consequences of the disease.

In the U.S., nearly 1.5 million men over 65 have osteoporosis and another 3.5 million men are at risk for developing the disease.

“Between their primary care physician and OB / GYN (obstetrician / gynecologist), women will begin bone density screenings at the appropriate age. Men are less likely to have routine primary care checkups and don’t receive preventative care similar to what is provided for women,” said Dr. Mary Ruppe, a Houston Methodist endocrinologist.

The American College of Physicians recommends men be assessed yearly for osteoporosis risk factors starting at age 50. The primary risk factor for men is family history, such as women in their family with osteoporosis or parents who suffered a hip fracture.

Other factors that can raise a man’s risk of osteoporosis are prescription steroid use, gastrointestinal disease, use of prostate cancer drugs and alcohol abuse. At age 70, the Endocrine Society recommends that all men begin routine bone density screenings as the risk for osteoporosis increases at this age.

Ruppe said osteoporosis treatment options for men are similar to those available for women. There are several approved medications that alter the cycle of bone formation and loss to help preserve bone strength. She said the key is diagnosing the condition so treatment can begin.

“Each year, approximately 80,000 men will suffer a hip fracture and studies have shown they have a higher mortality rate after a hip fracture than women of the same age,” Ruppe said.

“Such data underscores the importance of routine osteoporosis screening for men.”

Ruppe added that if a man is diagnosed with osteoporosis, his physician can begin treatment and order additional screenings to identify causes of low bone density that can cause other medical issues, such as Vitamin D deficiency or low testosterone levels.

A leading researcher at National Jewish Health is calling for men to be included in the screening guidelines for osteoporosis. Dr. Elizabeth Regan, PhD, studied more than 3,000 smokers and former smokers ages 45 to 80 and tested their bone density. What she found was surprising.

“We actually found that men were slightly more likely to have low bone density, and that they were slightly more likely to have vertebral fractures,” said Regan.

“In fact, 60% of the men had vertebral fractures compared to 40% of the women, while 55% of men had low bone density compared to 45% of women.”

Regan said this points to the need for the U.S. Preventive Services Task Force, which last updated osteoporosis screening guidelines in 2011, to consider adding at-risk men to their screening guidelines, which now include only women.

“I think that a sizable number of men who have low bone density are not getting diagnosed, and they’re not getting treated. And so they’re sustaining fractures that they could avoid. We need to change that,” said Regan.

Regan says screenings could be either the standard bone density scan or a CT scan, which is sometimes used to screen heavy smokers for cancer.

Former rancher Gary Hunter agrees. The 62-year-old suffers from Chronic Obstructive Pulmonary Disease and snapped a vertebra while picking up an oxygen tank that weighed only a few pounds. He was shocked to learn that his broken back was caused by osteoporosis.

“I’ve been active all my life. I’ve broken bones before,but never doing a simple task like that. I never dreamed that could happen to me,” said Hunter.

Dr. Mehrnaz Maleki, a rheumatologist at National Jewish Health, says that proper screening is essential, because many times a diagnosis of osteoporosis comes as a surprise.

“Normally osteoporosis does not have any signs, which is the problem. You might not have any pain or other signs that something might be wrong,” she said.

Maleki has these tips for osteoporosis prevention for both men and women:

  1. Take a calcium supplement.
  2. Take a vitamin D supplement, or spend 20 minutes outside every day to absorb sunshine, which boosts vitamin D levels.
  3. Eat a healthy diet rich in calcium.
  4. Stay active, especially with weight-bearing exercises.
  5. Don’t smoke.
  6. Don’t drink alcohol in excess.
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