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Elderly African-American and Caucasian men are infrequently screened for osteoporosis
J Steuart Richards1, Heather A Young, Robert DeSagun
1Rheumatology Section, Veterans Affairs Medical Center, Washington, DC 20422, USA. john.richards2@med.va.gov
Insights
Elderly males rarely undergo dual x-ray absorptiometry (DXA) for osteoporosis screening, with Caucasian men being significantly more likely to be screened than African American men, even with similar risk factors.
Area of Science:
- Rheumatology
- Geriatrics
- Radiology
- Public Health
Background:
- Osteoporosis screening with dual x-ray absorptiometry (DXA) is crucial for elderly males.
- Established risk factors for osteoporosis are often present in this demographic.
- Ethnic disparities in healthcare access and screening may exist.
Purpose of the Study:
- To identify factors prompting DXA requests in elderly male rheumatology patients.
- To investigate potential ethnic differences (African American vs. Caucasian) in DXA screening rates.
Main Methods:
- Retrospective review of 98 male patients' records in a rheumatology clinic.
- Data collected included demographics, osteoporosis risk factors, and DXA results (normal, osteopenic, osteoporotic).
- Logistic regression analysis was used to determine predictors of DXA requests.
Main Results:
- Only 14% of patients (3% of African Americans, 29% of Caucasians) received DXA.
- Caucasians were 7.69 times more likely to undergo DXA than African Americans.
- Ethnicity (OR 4.61) was the sole significant predictor for DXA requests, overriding factors like oral glucocorticoid use or rheumatoid arthritis.
Conclusions:
- DXA screening for osteoporosis is underutilized in elderly males, even with risk factors.
- Significant ethnic disparities exist, with African Americans being screened less frequently than Caucasians.
- Further research is needed to understand and address barriers to osteoporosis screening in minority populations.
Introduction:
To retrospectively examine the factors that initiated a request for dual x-ray absorptiometry (DXA) in elderly males in a rheumatology practice and to determine if there were differences between African Americans and Caucasians,
Materials And Methods:
The records of 98 consecutive male patients in the rheumatology clinic were reviewed for demographic data and risk factors and treatment for osteoporosis. DXA results were noted and classified as normal, osteopenic or osteoporotic.
Results:
There were 59 (60%) African Americans, 38 (39%) Caucasians and one (1%) Native American included for study. Fourteen patients had DXA-three (5%) among the African Americans and 11 (29%) among the Caucasians. Age was not found to be a significant predictor of obtaining DXA. Caucasians were 7.69 times more likely to have a DXA than African Americans. After adjusting for ethnicity, oral glucocorticoid use and rheumatoid arthritis were significant predictors of obtaining a DXA, although only 31% and 35% of patients on glucocorticoids or with rheumatoid arthritis, respectively, had DXA. Using a logistic regression model, ethnicity (odds ratio 4.61) remained the only significant predictor of requests for DXA.
Conclusion:
Male patients infrequently had DXA despite the presence of well-established risk factors for osteoporosis. Compared to Caucasians, fewer African Americans were screened even in the presence of similar risk factors for osteoporosis.
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