October 7, 2009

Old Men and Their Bones

While women are routinely warned about the risk of osteoporosis, older males suffer from it as well

Despite the prevailing cultural message that women are the only ones at risk of developing the bone-thinning ailment known as osteoporosis as they age, men can’t ignore the threat, experts say. Though osteoporosis is less common in men than in women, it takes a toll on both genders.

“It’s basically unrecognized,” says one physician about the problem. “The word on the street is that this is not a disease that guys get, and that is clearly incorrect.”

While a 50-year-old woman faces a 50 percent risk for an osteopathic fracture over her lifetime, anywhere from one in eight to one in four 50-year-old men have that same risk. The disease may be even more serious in men than in women, notes Felicia Cosman, medical director of the nonprofit National Osteoporosis Foundation. In hip fractures in men, for example, “the complication rate is higher; the death rate is higher,” she says.

The death rate for women is between 15 and 20 percent, and for men it stands between 20 and 25 percent. The reason for the difference is not clear, but Cosman suggests that men who fracture their hips are typically older than women and may be in poorer health.

Since 2000, researchers funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases have been studying 6,000 men, ages 65 and older, at six U.S. medical centers as well as sites abroad. They're focusing on men’s bone geometry, bone loss and fracture rates and other key topics.

Clifford Rosen, a professor of medicine at Tufts and the Maine Medical Center Research Institute, says the study can’t come soon enough. “I don’t think we have a good understanding of the epidemiology of this disease,” he says. “Men tend to come to physicians later, and we don’t understand what the natural history of this disease is in males.”

This article first appeared in the fall 2009 issue of Tufts Medicine magazine.

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