Osteoporosis International

, Volume 20, Issue 9, pp 1507–1515 | Cite as

Estimated prevalence and patterns of presumed osteoporosis among older Americans based on Medicare data

  • H. Cheng
  • L. C. Gary
  • J. R. Curtis
  • K. G. Saag
  • M. L. Kilgore
  • M. A. Morrisey
  • R. Matthews
  • W. Smith
  • H. Yun
  • E. Delzell
Original Article



Estimates of osteoporosis (OP) prevalence based on bone mineral density testing and fracture occurrence may be imprecise for small demographic groups. Medicare data are a useful supplemental source of information on OP.


We studied people ages ≥65 years covered by Medicare 2005. Cases of presumed OP were beneficiaries with physician services or inpatient claims for OP or for an associated fracture (hip, distal forearm, spine) in 1999–2005.


Among 911,327 beneficiaries with 6 or 7 years of Medicare coverage, the overall prevalence of OP and associated fractures was 29.7%. Prevalence was four times higher for women than men, increased with age, and was two times higher for whites, Hispanic Americans, and Asian Americans than African Americans. Among people with OP-associated fracture claims, the proportion with an OP diagnosis was 49.7% overall (women, 57.1%; men, 21.9%) and was lower for men than women and for African Americans than other ethnic groups.


The low proportion of beneficiaries who had an OP-associated fracture and also had an OP diagnosis, particularly among men and African American women, suggests suboptimal recognition and management of OP. Study limitations included lack of validation of our definition of OP and potential misclassification of race/ethnicity.


Epidemiology Fracture Osteoporosis Prevalence 


Conflict of interests

H. Cheng – no Conflict of interest; J. R. Curtis – Consulting: Roche, UCB, Procter & Gamble; speakers bureau: Merck, Procter & Gamble, Eli Lilly, Roche, Novartis; research grants: Merck, Procter & Gamble, Eli Lilly, Amgen, Novartis; K. G. Saag – Consulting: Amgen, Aventis, Eli Lilly, Merck, Novartis; Procter & Gamble, Roche, Savient, Takeda, UCB; speakers bureau: Novartis; research grants: Amgen, Eli Lilly, Novartis, Roche; M. L. Kilgore – Consulting and Research grants: Amgen, Eli Lilly; M. A. Morrisey, R. Matthews, W. Smith, H. Yun, E. Delzell and L. C. Gary – Research grants: Amgen.


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2009

Authors and Affiliations

  • H. Cheng
    • 1
  • L. C. Gary
    • 2
  • J. R. Curtis
    • 3
  • K. G. Saag
    • 3
  • M. L. Kilgore
    • 2
  • M. A. Morrisey
    • 2
  • R. Matthews
    • 1
  • W. Smith
    • 1
  • H. Yun
    • 2
  • E. Delzell
    • 1
  1. 1.Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Department of Health Care Organization and PolicyUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.Division of Clinical Immunology and RheumatologyUniversity of Alabama at BirminghamBirminghamUSA

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