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

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Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusions

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.

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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.

Author information

Authors and Affiliations

  1. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA

    H. Cheng, R. Matthews, W. Smith & E. Delzell

  2. Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA

    L. C. Gary, M. L. Kilgore, M. A. Morrisey & H. Yun

  3. Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA

    J. R. Curtis & K. G. Saag

Authors
  1. H. Cheng
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  2. L. C. Gary
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  3. J. R. Curtis
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  4. K. G. Saag
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  5. M. L. Kilgore
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  6. M. A. Morrisey
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  7. R. Matthews
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  8. W. Smith
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  9. H. Yun
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  10. E. Delzell
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Corresponding author

Correspondence to H. Cheng.

Additional information

This research was supported by a contract between the University of Alabama at Birmingham (UAB) and Amgen, Inc. Only the authors from UAB had access to the Medicare data used. The analysis, presentation, and interpretation of the results were solely the responsibility of the authors.

Appendix

Appendix

Table 6 Expanded fracture group 1 (EFX1): fracture sites possibly considered OP-related and corresponding ICD-9 codes
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Table 7 Expanded fracture group 2 (EFX2): fracture sites sometimes considered OP-related and corresponding ICD-9 codes
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Cheng, H., Gary, L.C., Curtis, J.R. et al. Estimated prevalence and patterns of presumed osteoporosis among older Americans based on Medicare data. Osteoporos Int 20, 1507–1515 (2009). https://doi.org/10.1007/s00198-009-0835-z

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  • DOI: https://doi.org/10.1007/s00198-009-0835-z

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