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. 2017 Jun;28(6):1979-1988.
doi: 10.1007/s00198-017-3996-1. Epub 2017 Mar 18.

Trends in osteoporosis and low bone mass in older US adults, 2005-2006 through 2013-2014

A C Looker  1 , N Sarafrazi Isfahani  2 , B Fan  3 , J A Shepherd  3
Affiliations

Trends in osteoporosis and low bone mass in older US adults, 2005-2006 through 2013-2014

A C Looker et al. Osteoporos Int. 2017 Jun.

Abstract

This study examined trends in osteoporosis and low bone mass in older US adults between 2005 and 2014 using bone mineral density (BMD) data from the National Health and Nutrition Examination Survey (NHANES). Osteoporosis and low bone mass appear to have increased at the femur neck but not at the lumbar spine during this period.

Introduction: Recent preliminary data from Medicare suggest that the decline in hip fracture incidence among older US adults may have plateaued in 2013-2014, but comparable data on BMD trends for this time period are currently lacking. This study examined trends in the prevalence of osteoporosis and low bone mass since 2005 using BMD data from NHANES. The present study also updated prevalence estimates to 2013-2014 and included estimates for non-Hispanic Asians.

Methods: Femur neck and lumbar spine BMD by DXA were available for 7954 adults aged 50 years and older from four NHANES survey cycles between 2005-2006 and 2013-2014.

Results: Significant trends (quadratic or linear) were observed for the femur neck (mean T-score and osteoporosis in both sexes; low bone mass in women) but not for the lumbar spine. The trend in femur neck status was somewhat U-shaped, with prevalences being most consistently significantly higher (by 1.1-6.6 percentage points) in 2013-2014 than 2007-2008. Adjusting for changes in body mass index, smoking, milk intake, and physician's diagnosis of osteoporosis between surveys did not change femur neck trends. In 2013-2014, the percent of older adults with osteoporosis was 6% at the femur neck, 8% at the lumbar spine, and 11% at either site.

Conclusions: There was some evidence of a decline in femur neck BMD between 2005-2006 and 2013-2014, but not in lumbar spine BMD. Changes in the risk factors that could be examined did not explain the femur neck BMD trends.

Keywords: Aging; General population studies; Osteoporosis.

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Figures

Figure 1.
Figure 1.
Flow chart showing sample sizes for the examined, excluded, and analytic sample by survey cycle
Figure 2.
Figure 2.
Unadjusted mean T-score at the femur neck and lumbar spine by sex and survey period, NHANES 2005–2014
Figure 3.
Figure 3.
Age-adjusted prevalence of selected risk factors by sex and survey period, NHANES 2005–2014
See this image and copyright information in PMC

References

    1. Looker AC, Melton LJ, Harris TB, Borrud LG, Shepherd JA. Prevalence and trends in low femur bone density among older US adults: NHANES 2005–2006 compared with NHANES III. Journal of Bone and Mineral Research 2010;25(1):64–71. doi: 10.1359/jbmr.090706. - DOI - PMC - PubMed
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    1. Zipf GCM, Porter KS, Ostchega Y, Lewis BG, Dostal J. National Health and Nutrition Examination Survey: Plan and Operations, 1999–2010. Hyattsville, MD: National Center for Health Statistics, 2013. - PubMed
    1. Schousboe JT, Shepherd JA, Bilezikian JP, Baim S. Executive summary of the 2013 International Society for Clinical Densitometry Position Development Conference on bone densitometry. J Clin Densitom 2013;16(4):455–66. doi: 10.1016/j.jocd.2013.08.004. - DOI - PubMed
    1. Centers for Disease Control and Prevention National Center for Health Statistics. Internet: http://www.cdc.gov/nchs/data/nhanes/nhanes_07_08/manual_dexa.pdf.

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