Poor health, but not fracture and fall risk, is associated with nonattendance at bone mineral density screening

Bone mineral density screening identifies women at risk for fracture. Nonattendance at screening is associated with subsequent hip fracture. Determining reasons for nonattendance may help in the designing of methods to improve screening.

We hypothesize that nonattenders may report poorer health and have a higher risk of fracture and fall. Women were randomly chosen from a list of people scheduled for a screening dual x-ray absorptiometry (DXA) scan. We used a validated telephone survey to calculate osteoporosis, fracture, and fall risk scores. Women answered questions about their health and medical conditions.

Of 263 women contacted, 226 (86%) women agreed to participate; 145 participants completed a dual-energy x-ray absorptiometry scan and 81 women failed to attend. Women who did not attend screening were more likely to report a serious medical condition (59.3% vs 46.9%; P = 0.09). Nonattenders were more likely to report their health as fair or poor (51.9% vs 33.8%; P = 0.01). There were no differences for osteoporosis, fall, and fracture risks.

Failure to attend osteoporosis screening is associated with significant health problems and poor self-rated health. Improving point of care access may increase the amount of osteoporosis screening among women with multiple comorbidities.