PREVALENCE AND ASSOCIATED RISK FACTORS OF OSTEOPOROSIS AMONG ELDERLY PATIENTS IN AL-AHSA REGION, SAUDI ARABIA: A CROSS-SECTIONAL STUDY

Background: Osteoporosis, an ageing bone disease, where the bone mineral density and bone mass decreases leading to decrease in the bone strength ,is a leading cause of bone fracture among the older population. Multiple risk factors participate in developing the osteoporosis which include age, gender, previous fractures, family history of osteoporosis diet deficient in calcium, sedentary lifestyle, Body Mass Index (BMI) ,smoking, corticosteroid medication, or having hyperparathyroidism and chronic liver disease. The present study was conducted to assess prevalence of osteoporosis and to determine its risk factors in Al Ahsa district of Saudi Arabia in order to control and manage this condition.

Material and Methods:It was a cross-sectional study conducted at all the primary health care centers of Al Ahsa district of Saudi Arabia. All the patients with bone ailment over 60 years of age attending the Primary Health Care Centers for their bone ailment were the study population. The minimum sample size for this study has been calculated to be 384.A probability sampling in form of multistage stratified random sampling technique was used to select the sample. A special data sheet was prepared based on a similar earlier study, The data were entered and analyzed by using the statistical package for social sciences, version 21 .Descriptive statistics were presented using counts, proportions (%), mean ± standard deviation whenever appropriate/ The association of risk factors with the osteoporosis was tested by chi square test .Logistic regression analysis was also done for comparative study. A p-value cut off point of 0.05 at 95% CI was used to determine statistical significance.

Results:A total of 422 patients attended the selected PHCs for the treatment of bone ailment making the response rate of 90%. The mean age of the patients was 67.36 years Std. Dev. 6.46 years (Range 60-91 years).The sex of the patients were almost equally distributed (Male: 50.1%, Female: 49.1%).More than sixty one percent of the patients were detected on DXA as suffering from osteopenia (27.3%) and osteoporosis (34%). Majority of them (55.5%) had all the signs of osteoporosis while the rest had osteopenia on DXA. On logistic regression analysis, obese patients over 60 years old were having almost 3 times more risk to develop osteopenia and osteoporosis than those with normal weight (OR2.77, 95% CI 1.48-6.25, P= 0.032 ) . Similarly those patients who had family history of osteoporosis were 5 times more likelihood of developing osteopenia and osteoporosis (OR:5.56  95% CI 2.58-8.34, P = 0.003) .The patients with smoking habit, those who were suffering from liver disease and those who were not involved in physical exercise were 3.5 times ( OR 3,56 , 95% CI 1.58-634, P= 0.032 ) , 4 times (OR 4.32 , 95% CI 2.12-5.63, P= 0.045 ) and 2,7 ( OR  2.77 , 95% CI 1.48-6.25, P= 0.032 ) times likelihood of developing osteopenia and osteoporosis among the patients above 60 years of age.

Conclusion:The present study has provided vital information on the prevalence of osteoporosis among the elderly population of Al Ahsa region of Saudi Arabia. Osteoporosis is a leading cause of fracture of bone among the elderly population leading to morbidity. The high prevalence of osteoporosis in this region necessitates developing an effective awareness programme among the elderly population for the prevention of osteoporosis at least by controlling the modifiable risk factors.