BMI and low bone mass in an elderly male nursing home population

Miguel A Paniagua¹, Julie E Malphurs², Luis F Samos¹

¹VA Medical Center GRECC and University of Miami Miller School of Medicine, Department of Medicine, Division of Gerontology and Geriatric Medicine, Miami, FL, USA; ²VA Medical Center, Mental Health and Behavioral Sciences Service, and University of Miami Miller School of Medicine, Department of Psychiatry and Behavioral Sciences, Miami, FL, USA

Introduction: Little is known about osteoporosis in institutionalized older adults. Risk factors such as low body mass index (BMI) have been investigated in female populations, but remain understudied in men. The objective of this study was to examine characteristics of older men residing in a nursing home who received bone mineral density evaluations.

Methods: 57 male Miami Veterans Affairs Medical Center (VAMC) nursing home residents were screened for osteoporosis using a peripheral dual X-ray (pDXA) technique. T-scores were categorized into three groups: normal (0>–1); osteopenic (–1 to –2.49); osteoporotic (<–2.5).

Results: Average age was 76.2 years (standard deviation = 11.5; range: 48–100). T-scores indicated that 37.3% of the population was normal, 35.6% osteopenic, and 27.1% osteoporotic. 35.6% of patients had normal BMIs, 3.4% were underweight, 47.5% were overweight, and 13.6% were considered obese. There was a high prevalence of overweight and obese individuals (61.1%) in the osteopenic and osteoporotic groups.

Conclusion: As expected, there was a high prevalence of low bone mass in our population (62%). However, overweight and obese men were more likely to have osteoporosis and osteopenia, contrary to literature and clinical knowledge. This finding may be partially explained by the prevalence of sedentary lifestyle and relative lack of weight-bearing activity in this group of men.

Keywords: osteoporosis, nursing home, aging, body mass index