Evaluation of Current Decision Rules and Healthcare Professional Practices for Detecting Osteoporosis Risk in the Young Adult Population

Abstract

Osteoporosis is caused by a multitude of factors. An individual’s risk for experiencing a bone fracture as a senior citizen increases without early intervention. Healthcare professionals do not have access to validated survey tools to identify young adults in need of osteoporosis prevention education, although survey tools to identify postmenopausal women at high risk for low bone mass are available. The purposes of this study were to evaluate three of these survey tools for use in a younger population, and to determine if young adults with osteoporosis risk factors received bone health education from a health professional. Forty-two men and 41 women completed surveys and health questionnaires; responses were compared to bone mineral density (BMD) and content (BMC) measurements. Healthcare professionals discussed bone health with only 13% of participants. Chi-square analysis revealed that health professionals were not more likely to discuss osteoporosis with subjects based on age or gender. Participants with T-scores ≤ -1.0 were not more likely to receive bone health education. Area under the receiving operating characteristic (AUROC) curves analysis revealed that no survey tools were able to identify moderate-risk participants at T-scores ≤ -1.0, and AUROC curves for all surveys did not exceed 0.525 at this level. Two surveys detected participants at high risk for bone disease with identical AUROC curves of 0.821 at a T-score ≤ -2.0, and 0.813 at a T-score ≤ -2.5. The AUROC curves indicate that current tools designed for older women do not detect young adults with moderately low T-scores.