High prevalence of multiple and severe vertebral fractures in male geriatric outpatients

Introduction: to investigate prevalence and underlying risk factors for vertebral fractures in male geriatric outpatients on radiographs of the thoracolumbar spine. Methods: 176 men, mean age 80 years, first‐time visiting a geriatric day hospital, underwent a comprehensive geriatric assessment, routine laboratory investigation and lateral X‐rays of the chest and lumbar spine. The presence of vertebral fractures was assessed by using a semi‐quantitative method. Co‐morbidity, use of medication, mobility, falls, and cognitive decline were scored. Results: Prevalent vertebral fractures were found in 85 of 176 men (48%). In the men with a vertebral fracture, 52% (44/85) had moderate and/or severe fractures and 40% (34/85) had at least two vertebral fractures. None of the measured variables could be identified as a risk factor for the presence of vertebral fractures in this population. Conclusion: This study showed a high prevalence of vertebral fractures among male geriatric patients. Roughly half of the ones with a vertebral fracture had a moderate and/or severe fracture, and 40% had multiple fractures, indicating severe underlying osteoporosis and high risk of future vertebral and non‐vertebral fractures. These findings in combination with the silent occurrence, lack of risk factors to identify these patients clinically and the availability of effective and relatively safe anti‐osteoporotic medication, suggest that it is advisable to screen all male patients who visit a geriatric day clinic with radiography of the spine.