ABSTRACT
OBJECTIVE: To evaluate the prevalence of previously unrecognized osteoporosis in men admitted for long-term rehabilitation nursing home care. DESIGN: Cross-sectional study. METHODS: A total of 1179 consecutive admissions to a VA rehabilitation center were reviewed. Men who were already diagnosed with osteoporosis, had confounding medical illness, were unable to complete the study, or who declined to participate were excluded. A total of 153 patients were enrolled and 106 were evaluated. Measurements included dual-energy X-ray absorptiometry of the hip and lumbar spine, biochemical and hormonal studies, and functional evaluation. RESULTS: A total of 33 patients (31.1%) had osteoporosis (T-score at any site lumbar spine, total hip, or femoral neck <-2.5). Patients with osteoporosis were significantly older than those without: 68.4 +/- 13.2 years versus 62.7 +/- 12.1 years (P <.05), respectively. Body mass index (BMI) and weight were lower in men with osteoporosis: 23.4 +/- 3.9 kg/m2 versus 28.7 +/- 7.08 kg/m2 and 72.6 +/- 14.4 kg versus 90.3 +/- 23.8 kg, respectively (both, P <.001). There were no differences in use of medications thought to affect bone metabolism or functional status, or in hormonal and metabolic measurements. Hip and spine bone density were correlated (r = 0.3, P <.05). Multivariate analysis showed that hip bone density was independently associated with BMI. CONCLUSION: Hip osteoporosis is common in this unscreened population, suggesting that screening should be more widely performed in veterans admitted to rehabilitation units. These data suggest that nutritional status could impact osteoporosis risk.
