Skip to main content
Log in

Performance of risk assessment tools for predicting osteoporosis in south Indian rural elderly men

  • Original Article
  • Published:
Archives of Osteoporosis Aims and scope Submit manuscript

Abstract

Summary

Osteoporosis in elderly men is an under-recognized problem. In the current study, we intend to look at the performance of two risk assessment tools [OSTA and MORES] for the diagnosis of osteoporosis. Osteoporosis was seen in 1/4th of elderly men at spine and 1/6th of them at femoral neck. Both risk assessment tools were found to have good sensitivity in predicting osteoporosis at spine and femoral neck with good area under curve (AUC).

Purpose

This study attempts to look at the performance of osteoporosis self-assessment tool for Asians (OSTA) and male osteoporosis risk estimation score (MORES) for predicting osteoporosis in south Indian rural elderly men.

Methods

Five hundred and twelve men above 65 years of age from a south Indian rural community were recruited by cluster random sampling. All subjects underwent detailed clinical, anthropometric, and bone mineral density measurement at lumbar spine and femoral neck using dual-energy X-ray absorptiometry scan. A T score ≤ − 2.5 was diagnostic of osteoporosis. Scores for OSTA and MORES were calculated at various cut offs, and their sensitivities and specificities for predicting osteoporosis were derived.

Results

The prevalence of osteoporosis was found to be 16% at femoral neck and 23% at spine. OSTA with a cut-off value of ≤2 predicted osteoporosis with a sensitivity and specificity at lumbar spine of 94 and 17% and at femoral neck of 99 and 18%. The area under ROC curve for OSTA index for spine was 0.716 and for femoral neck was 0.778. MORES with a cut-off value of ≥6 predicted osteoporosis at spine with a sensitivity of 98% and specificity of 15%, and at femoral neck, they were 98 and 13%, respectively. The area under ROC curve for MORES for spine was 0.855 and for femoral neck was 0.760.

Conclusion

OSTA and MORES were found to be useful screening tools for predicting osteoporosis in Indian elderly men. These tools are simple, easy to perform, and cost effective in the context of rural Indian setting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kanis JA, Johnell O, Oden A, Laet CD, Mellstrom D (2004) Epidemiology of osteoporosis and fracture in men. Calcif Tissue Int 75(2):90–99

    Article  CAS  PubMed  Google Scholar 

  2. Haentjens P, Magaziner J, Colón-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B et al (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152(6):380–390

    Article  PubMed  PubMed Central  Google Scholar 

  3. Mithal A, Bansal B, Kyer CS, Ebeling P (2014) The Asia-Pacific regional audit-epidemiology, costs and burden of osteoporosis in India 2013: a report of international osteoporosis foundation. Indian J Endocrinol Metab 18(4):449–454

    Article  PubMed  PubMed Central  Google Scholar 

  4. Marwaha RK, Tandon N, Garg MK, Kanwar R, Narang A, Sastry A et al (2011) Bone health in healthy Indian population aged 50 years and above. Osteoporos Int 22(11):2829–2836

    Article  CAS  PubMed  Google Scholar 

  5. Shetty S, Kapoor N, Naik D, Asha HS, Prabu S, Thomas N, et al. Osteoporosis in healthy South Indian males and the influence of life style factors and vitamin d status on bone mineral density. J Osteoporos. 10.1155/2014/723238

  6. Agrawal NK, Sharma B (2013) Prevalence of osteoporosis in otherwise healthy Indian males aged 50 years and above. Arch Osteoporos 8:116

    Article  PubMed  Google Scholar 

  7. U.S. Preventive Services Task Force (2002) Screening for osteoporosis in postmenopausal women: recommendations and rationale. Ann Intern Med 137(6):526–528

    Article  Google Scholar 

  8. Genant HK, Cooper C, Poor G, Reid I, Ehrlich G, Kanis J et al (1999) Interim report and recommendations of the World Health Organization task-force for osteoporosis. Osteoporos Int 10(4):259–264

    Article  CAS  PubMed  Google Scholar 

  9. Chen S-J, Chen Y-J, Cheng C-H, Hwang H-F, Chen C-Y, Lin M-R (2016) Comparisons of different screening tools for identifying fracture/osteoporosis risk among community-dwelling older people. Medicine (Baltimore) 95(20):e3415

    Article  Google Scholar 

  10. Cass AR, Shepherd AJ, Asirot R, Mahajan M, Nizami M (2016) Comparison of the male osteoporosis risk estimation score (MORES) with FRAX in identifying men at risk for osteoporosis. Ann Fam Med 14(4):365–369

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bhat KA, Kakaji M, Awasthi A, Kumar K, Mishra K, Shukla M et al (2016) Utility of osteoporosis self-assessment tool as a screening tool for predicting osteoporosis in Indian men. J Clin Densitom. doi:10.1016/j.jocd.2016.04.005

    Google Scholar 

  12. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994;843:1–129

  13. Cass AR, Shepherd AJ (2013) Validation of the male osteoporosis risk estimation score (MORES) in a primary care setting. J Am Board Fam Med 26(4):436–444

    Article  PubMed  Google Scholar 

  14. Koh LK, Sedrine WB, Torralba TP, Kung A, Fujiwara S, Chan SP et al (2001) A simple tool to identify asian women at increased risk of osteoporosis. Osteoporos Int 12(8):699–705

    Article  CAS  PubMed  Google Scholar 

  15. Yang Y, Wang B, Fei Q, Meng Q, Li D, Tang H et al (2013) Validation of an osteoporosis self-assessment tool to identify primary osteoporosis and new osteoporotic vertebral fractures in postmenopausal Chinese women in Beijing. BMC Musculoskelet Disord 14:271

    Article  PubMed  PubMed Central  Google Scholar 

  16. Richy F, Gourlay M, Ross PD, Sen SS, Radican L, De Ceulaer F et al (2004) Validation and comparative evaluation of the osteoporosis self-assessment tool (OST) in a Caucasian population from Belgium. QJM 97(1):39–46

    Article  CAS  PubMed  Google Scholar 

  17. Steuart Richards J, Lazzari AA, Teves Qualler DA, Desale S, Howard R, Kerr GS (2014) Validation of the osteoporosis self-assessment tool in US male veterans. J Clin Densitom 17(1):32–37

    Article  CAS  PubMed  Google Scholar 

  18. Zha X-Y, Hu Y, Pang X-N, Chang G-L, Li L (2015) Diagnostic value of osteoporosis self-assessment tool for Asians (OSTA) and quantitative bone ultrasound (QUS) in detecting high-risk populations for osteoporosis among elderly Chinese men. J Bone Miner Metab 33(2):230–238

    Article  PubMed  Google Scholar 

  19. Nayak S, Edwards DL, Saleh AA, Greenspan SL (2015) Systematic review and meta-analysis of the performance of clinical risk assessment instruments for screening for osteoporosis or low bone density. Osteoporos Int 26(5):1543–1554

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Thomas Vizhalil Paul.

Ethics declarations

Conflict of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Satyaraddi, A., Shetty, S., Kapoor, N. et al. Performance of risk assessment tools for predicting osteoporosis in south Indian rural elderly men. Arch Osteoporos 12, 35 (2017). https://doi.org/10.1007/s11657-017-0332-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11657-017-0332-5

Keywords

Navigation