Poster Presentation Annual Meetings of the Endocrine Society of Australia and Society for Reproductive Biology and Australia and New Zealand Bone and Mineral Society 2016

Male osteoporosis awareness in the elderly. An analysis of DXA use in Australia 1995 to 2015 (#297)

Weiwen Chen 1 2 , Nicholas Pocock 1 2
  1. Garvan Institute, Darlinghurst, NSW, Australia
  2. St Vincent's Hospital, St Vincent's Hospital Clinical School, Darlinghurst, NSW, Australia

Health professional awareness of osteoporosis has improved significantly over the last 2 decades.  Osteoporosis is however commonly perceived to be a disease mainly of females. There is little data on relative gender DXA utilization in the elderly. Data for all Medicare DXA claims were obtained between 1995 and 2015 to investigate gender differences of DXA utilization in the elderly. 

Results: In females and males aged 64-74, 75-84 or ≥ 85 years of age there was a progressive increase in DXA claims per capita between 1994 and 2002, with little change thereafter in females but slow increase in males until 2007.  After 2007, following introduction of Medicare eligibility criterion for age over 70, claims increased sharply in all three age groups, with ongoing increase in Medicare claims per capita subsequently. The male/female claim ratio in all age groups demonstrate low relative DXA use in males compared to females with the male/female ratio significantly below 1.0. Following the 2007 Medicare criterion for age over 70, the male/female ratio DXA scans improved slightly in the 64-74 and 75-84 age groups with little subsequent change thereafter.  Conversely in males over 85 the relative use of DXA, compared to females, has improved steadily over the last 20 years predating, and continuing since, the 2007 Medicare change.

Discussion: In very elderly males aged over 85, there is an ongoing improvement in DXA utilization possibly reflecting increasing awareness of high fracture risk in this group by health care professionals. Importantly however in the age groups 64-74 and 75-84, while DXA use per capita has increased, the male/female ratio of DXA utilization remains low with little improvement after the introduction of the Medicare rebate for age over 70.

Conclusion:  There is a need for improved education of health professionals about the risk of osteoporosis in males aged 64-85.