Gender Differences in Osteoporosis and Fractures

Abstract

Background Osteoporosis is generally thought of as a ''woman's disease'' because the prevalence of osteoporosis and the rate of fractures are much higher in postmenopausal women than in older men. However, the absolute number of men affected by osteoporosis and fractures is large, as at least 2.8 million men in the United States are thought to have osteoporosis. Questions/purposes The purposes of this review are to (1) highlight gender differences in osteoporosis and fracture risk, (2) describe disparities in treatment and outcomes after fractures between men and women, and (3) propose solutions to reducing disparities in treatment and prevention. Methods A literature survey was conducted using MEDLINE with a variety of search terms and using references from the author's personal collection of articles. A formal search strategy and exclusion criteria were not employed and the review is therefore selective. Where are we now? Postmenopausal women have a higher prevalence of osteoporosis and greater incidence of fracture than older men. Despite the higher fracture risk in postmenopausal women, older men tend to have worse outcomes after fracture and poorer treatment rates, although less is known about the disease course in men.Multifaceted interventions to improve the screening and treatment for osteoporosis were recently developed. Where do we need to go? Improvement in treatment rates of those at risk, regardless of gender, is an important goal in osteoporosis management. How do we get there? Further development and evaluation of cost-effective, multifaceted interventions for screening and treatment of osteoporosis and fractures are needed; such interventions will likely improve the primary prevention of fractures.

Concomitant upper limb and hip fractures in older adults - does the site matter? A retrospective clinical observation study

“…Similar findings were noted in previous concomitant upper limbs fracture studies; [5][6][7][8] this is consistent with higher fracture rates in elderly women due to the higher prevalence of osteoporosis. 24 Our study has inherent limitations of being a retrospective cohort study based on ICD-10 coding. Limitations include variability in electronic and written records, coder's trainingand experience and coder's error (such as misspecification, unbundling and upcoding).…”

The 1000 lumbar spine radiograph study

“…This might be because osteoporosis is generally thought of as a "woman's disease." The prevalence of osteoporosis and the rate of fractures are much higher in postmenopausal women than in older man (Cawthon 2011). Moreover, men tend to have worse outcomes after fracture (Cawthon 2011).…”

“…The prevalence of osteoporosis and the rate of fractures are much higher in postmenopausal women than in older man (Cawthon 2011). Moreover, men tend to have worse outcomes after fracture (Cawthon 2011). Thus, this could lead to investigate further by requesting an MRI after a lumbosacral spine X-ray.…”

Geriatric falls and risk factors

“…From the 10 million residents of Hungary, it is estimated that in the population over 50 years of age 547,107 people suffered from osteoporosis, of which 94,949 were males and 452,158 were females in 2010 [22,23]. Similar prevalence rates were found in the European Union, while the rate was higher in the U.S.A. [18,22,23]. Amongst fall-related low-energy bone fractures, hip fractures are the most significant consequences of osteoporosis: they put a huge financial burden on the health care system and on the patients as well, besides extreme pain and high morbidity and mortality rates.…”

“…Other than medication use, many studies have revealed a variety of factors or conditions that can increase the risk of falling in elderly patients, such as older age, comorbidities, vitamin D deficiency, vision disturbances, diabetes, depression and osteoporosis [6,8,18]. In the present thesis, osteoporosis and serum vitamin D level have been studied as risk factors for falls (and fractures).…”