Background: Osteoporosis and low bone mass are major public health threats for an estimated 44 million Americans or 55% of the population aged 50 years and older. However, osteoporosis has long been seen as a women's disease due to the huge difference in recorded prevalence of osteoporosis between men and women.
Objectives: The objective of this study is to examine the difference in awareness of osteoporosis and bone mass density (BMD) testing between older male and female Medicare beneficiaries living in the community.
Methods: This study is a pooled cross-sectional study using 2016-2018 Medicare Current Beneficiary Survey (MCBS) data linked with Medicare claims. The study sample included Medicare beneficiaries aged 65 years and older living in the community. The outcome variables were awareness of osteoporosis and BMD testing captured in survey responses. The main independent variable was sex identified from Medicare administrative records. We first conducted descriptive analysis on the characteristics of the sample and the unadjusted awareness of osteoporosis and BMD testing between males and females while adjusting for the covariates.
Results: The final study sample consisted of 19,106 male and 22,686 female community-dwelling Medicare beneficiaries. Males had much lower awareness of osteoporosis (13.7% for male vs. 58.9% for female, p< 0.0001) and BMD testing (67.3% for male vs. 86.8% for female, p< 0.0001), and the gap was larger among those without evidence of osteoporosis than among those with evidence of osteoporosis. The results from survey logistic regression models showed that males were always less likely to be aware of osteoporosis and BMD testing than their female counterparts regardless of evidence of osteoporosis.
Conclusions: Compared to older female Medicare beneficiaries, older male Medicare beneficiaries were less aware of osteoporosis and BMD testing. Efforts should be targeted to raise awareness of osteoporosis and BMD testing in older male Medicare beneficiaries.
