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Osteoporosis and osteopenia are increasingly prevalent conditions among older adults. Not only do the fractures associated with poor bone health have significant health consequences for the individual, but also their economic impact is placing increasing financial burden on governments and society. This study aimed to determine the direct economic cost of osteoporosis, osteopenia, and fractures among Australians aged 50 years and older in 2017. This study uses previous Australian data on the incidence and prevalence of osteoporosis and osteopenia together with recent Australian data on health service utilization after fracture to provide an estimate of the economic burden of osteoporosis. A bottom‐up costing approach was used to determine the average direct health care and non‐health care total costs of a fracture, as well as the average community health service costs of managing individuals with osteoporosis or osteopenia. The total direct cost of osteoporosis in Australia in 2017 was estimated to be $3.44 billion (AUD 2017, USD 2.77 billion). Treatment of fractures accounted for 68% of total direct costs, and non‐fracture management of osteoporosis accounted for 32%. Hip fractures accounted for the highest proportion (43%) of the total direct cost of fractures, although fractures at “other” sites accounted for 38.5%. Fractures among individuals aged 70 years and older accounted for 74% of the direct costs (55% and 19% in women and men, respectively). Fracture costs in those with osteopenia accounted for 50% of direct fracture treatment costs. This up‐to‐date cost analysis estimated that costs in 2017 were three times higher than in 2007. These estimates will aid clinicians, policy makers, researchers, and health care organizations to acknowledge the economic importance of reducing osteoporosis‐related fractures and associated costs. This provides a strong public health case to promote bone health that will assist in reducing future fracture‐related costs. © 2018 American Society for Bone and Mineral Research.

The role of medical conditions, childhood experiences, and psychological and relationship factors in the development and maintenance of male sexual difficulties is not well understood. Using self-report questionnaires, the current study examined how these factors are associated with male sexual difficulties overall, as well as for each of four separate problems (low sexual desire, erectile difficulties, premature ejaculation, delayed ejaculation). The participants for the study were 331 Australian men from the general population, all of whom were in cohabiting heterosexual relationships and had experienced one or more of the aforementioned sexual problems. Data were collected via an online survey between January 2010 and April 2011. The results demonstrated that medical factors as well as current psychological factors (e.g., performance anxiety) were most likely associated with each male sexual difficulty. These findings are in contrast to those obtained with women, where relationship factors are strongly related to female sexual problems. They would suggest that the targets for sex therapy may be different for men and women, with medical problems and performance anxiety being the primary targets for men.

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The current study evaluated a new program designed to improve mental and physical health among middle-age men. The program focused on increasing awareness of health behaviors such as diet, exercise and on improving positive body image messages, self-efficacy and coping skills. Seventy-six men aged 40 to 65 years participated in the study, with 43 men in the intervention group (M = 51.40 years; SD = 7.52 years) and 33 men in the waitlist control group (M = 54.93 years; SD = 4.81 years). Participants in the intervention group attended a 90 min workshop each week for 4 consecutive weeks. Measures of the above target variables were taken preprogram, postprogram, and at 3-month follow-up. The program was effective in improving numerous adaptive coping strategies and body fat percentage at follow-up. In addition, trends toward improving healthy lifestyle factors were observed. Other measures, including self-efficacy and body image, did not reveal significant improvements as a result of the intervention. Findings are discussed in terms of previous research and suggestions for future prevention programs.

Major osteoporotic fractures (MOFs) are associated with a rapid decline in health‐related quality of life (HRQoL); however, there is limited knowledge about which healthcare services positively affect HRQoL postfracture. This study aimed to identify specific combinations of health service use associated with recovery of HRQoL 12 months post‐MOF. The analyses included 4126 adults aged ≥50 years with an MOF (1657 hip, 1354 distal forearm, 681 vertebrae, 434 humerus) participating in the International Costs and Utilities Related to Osteoporotic fractures Study (ICUROS), a multinational observational study (Australia, Austria, Estonia, France, Italy, Lithuania, Mexico, Russia, Spain, United Kingdom, and United States). HRQoL at prefracture and 12 months postfracture was measured using the EuroQoL questionnaire (EQ‐5D‐3L). Health service use data were collected via participant interviews and medical record reviews including in‐hospital care; outpatient care; community services; and medication use. Data analyses involved two stages: (i) latent class analyses to identify different combinations of health service use (“classes”); and (ii) logistic regression to assess effects of classes on HRQoL recovery. Analyses were repeated excluding hip fractures (non‐hip MOFs). Overall, 2057 MOF participants (49.9%) recovered to their prefracture HRQoL at 12‐month follow‐up; this proportion was higher for non‐hip MOFs (n = 1439; 58.3%). Several distinct classes were identified across countries (range, 2–5 classes). Classes that were associated with increased odds of HRQoL recovery were characterized by a combination of hospital presentations without admission; outpatient department visits; allied health visits; vitamin D/calcium supplementation; and/or non‐opioid analgesic use. Similar classes were observed for non‐hip MOFs. Understanding country‐specific healthcare service pathways that influence greater recovery of HRQoL, particularly services that are uncommon in some countries and routine in others, could improve postfracture care on a global scale. © 2020 American Society for Bone and Mineral Research (ASBMR).

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