Osteoporosis assessment strategies for male nursing home residents

Objectives: Twenty-five to thirty percent of hip fractures occur in men, and nursing home residents have a 5–10-fold greater fracture risk than community-dwellers. Osteoporosis prevalence in men in long-term care, however, is poorly defined. Our objectives were to determine the prevalence of osteoporosis, as assessed by peripheral bone mineral density (BMD), in a group of institutionalized veterans, and to determine how many men with low BMD had received a prior diagnosis of osteoporosis. Methods: Subjects were residents in a 740-bed skilled nursing facility (78% men). Male residents ( n=103) competent to give informed consent underwent bilateral calcaneal and forearm BMD by dual-energy X-ray absorptiometry (DXA). Prior osteoporosis documentation was sought in medical records. Results: Twenty percent of veterans (95% confidence interval (CI) 12–28%) exhibited calcaneal osteoporosis ( T-score < −2.5), and 62% (CI 52–72%) were osteoporotic at the forearm. Forearm and calcaneal BMD were correlated ( r=0.678, P