Even though one in four men over age 50 will sustain a fracture because of osteoporosis, few are getting screened and treated for the disease, a new study shows.
Researchers found that compared to women, men are nearly 10 times less likely to receive a bone density scan after fracturing a wrist, according to a report published in the Journal of Bone and Joint Surgery. Worldwide, 1 in 3 women over 50 will experience an osteoporosis-related broken bone, according to the International Osteoporosis Foundation.
Both men and women who have broken a wrist and who suffer from osteoporosis are at heightened risk for a hip fracture. But the consequences for men can be more deadly since men have twice the mortality rate of women during the initial hospitalization and first year after a hip fracture.
“My take-home point is that this is not just a women’s disease,” said study coauthor Dr. Tamara D. Rozental, an associate professor of orthopedic surgery at Harvard Medical School. “You should think about it and have a conversation with the treating orthopedic surgeon if you have a fracture.”
Fracturing a wrist in a fall may be the first warning sign that osteoporosis is present.
“Wrist fractures are the earliest of the fragility fractures and they tend to show up 10 to 15 years before a hip or spine fracture,” Rozental said.
Why are doctors failing to screen men for osteoporosis?
Like most of us they still think of the brittle bone disease as something that strikes only women, Rozental said.
Rozental and her colleagues reviewed the medical records of 95 men and 344 women who were over the age of 50 and who had been treated for a wrist fracture at the Beth Israel Deaconess Medical Center over a five-year period.
After taking into account factors such as age and a prior history of fracture, the researchers calculated that men were 9.7 times less likely than women to be given a bone density scan after a wrist fracture. Among those diagnosed with osteoporosis, men were 15.7 times less likely than women to be started on bisphosphonate therapy (bone density medications), and five times less likely to be started on calcium and vitamin D supplementation.
Experts agreed that men and their doctors need to be more alert to the possibility of osteoporosis when there has been a fracture.
“It is important for doctors to recognize when a man has a fracture in his mid-40s or -50s and has a history of being sedentary that a [bone density] scan is reasonable,” said Dr. Andrew Schwartz, an associate professor of orthopedic surgery and associate professor of pathology and laboratory medicine at the University of California, Los Angeles. “Ground-level falls shouldn’t break anything, though obviously you can if you land in an awkward position. But even then you’re more likely to have a sprain than a fracture.”
Americans’ sedentary lifestyle may take much of the blame for osteoporosis in men.
“So many people tell me they walk every day,” Schwartz said. “But that’s not really doing anything for your legs unless you’re walking up and down The jolting bones take during jogging or running is what makes them denser. You need to do something that has impact. Even someone with a back problem can do a little jogging.”
The jolting bones take during jogging or running is what makes them denser, Schwartz explained.
Dr. David Bozentka hopes the new study will remind doctors to look for brittle bones in men as well as in women.
“Quite often there is a higher suspicion in women,” said Bozentka, chief of orthopedic surgery at the Penn Presbyterian Medical Center. “We forget that men get it as well. It’s important that we make sure we assess them.”
For men who want to stave off osteoporosis, "stay active with weight-bearing exercise and make sure vitamin D and calcium intake is appropriate," said Bozentka.
Linda Carroll is a regular contributor to NBCNews.com and TODAY.com. She is co-author of "The Concussion Crisis: Anatomy of a Silent Epidemic” and the recently published “Duel for the Crown: Affirmed, Alydar, and Racing’s Greatest Rivalry”