• Margaret L Gourlay, Robert A Overman, Jason P Fine, Guillaume Filteau, Peggy M Cawthon, John T Schousboe, Eric S Orwoll, Timothy J Wilt, Tuan V Nguyen, Nancy E Lane, Pawel Szulc, Brent C Taylor, Thuy-Tien Dam, Carrie M Nielson, Jane A Cauley, Elizabeth Barrett-Connor, Howard A Fink, Jodi A Lapidus, Deborah M Kado, Susan J Diem, Kristine E Ensrud, and Osteoporotic Fractures in Men (MrOS) Research Group.
• Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina. Electronic address: margaret_gourlay@med.unc.edu.
• Am J Prev Med. 2016 Jun 1; 50 (6): 727736727-736.

IntroductionFor older men who undergo bone mineral density (BMD) testing, the optimal osteoporosis screening schedule is unknown. Time-to-disease estimates are necessary to inform screening intervals.MethodsA prospective cohort study of 5,415 community-dwelling men aged ≥65 years without hip or clinical vertebral fracture or antifracture treatment at baseline was conducted. Participants had concurrent BMD and fracture follow-up between 2000 and 2009, and additional fracture follow-up through 2014. Data were analyzed in 2015. Time to incident osteoporosis (lowest T-score ≤ -2.50) for men without baseline osteoporosis, and time to hip or clinical vertebral fracture or major osteoporotic fracture for men without or with baseline osteoporosis, were estimated.ResultsNine men (0.2%) with BMD T-scores >-1.50 at baseline developed osteoporosis during follow-up. The adjusted estimated time for 10% to develop osteoporosis was 8.5 (95% CI=6.7, 10.9) years for those with moderate osteopenia (lowest T-score, -1.50 to -1.99) and 2.7 (95% CI=2.1, 3.4) years for those with advanced osteopenia (lowest T-score, -2.00 to -2.49) at baseline. The adjusted times for 3% to develop a first hip or clinical vertebral fracture ranged from 7.1 (95% CI=6.0, 8.3) years in men with baseline T-scores > -1.50 to 1.7 (95% CI=1.0, 3.1) years in men with baseline osteoporosis.ConclusionsMen aged 65 years and older with femoral neck, total hip, and lumbar spine BMD T-scores >-1.50 on a first BMD test were very unlikely to develop osteoporosis during follow-up. Additional BMD testing may be most informative in older men with T-scores ≤-1.50.Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

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