Some women in SG more inclined to undergo osteoporosis assessment, study finds

In Singapore, sociodemographic and clinical factors as well as risk perception and health beliefs influence the willingness of perimenopausal and menopausal women to undergo Bone Mineral Densitometry for osteoporosis assessment, according to a study.

In a cohort of women at least 50 years of age who were recruited via convenience sampling from a cluster of public primary care clinics in Singapore in 2022, factors such as history of fractures, Chinese ethnicity, older age, risk perception score, and exercise benefits score emerged as significant predictors of the willingness to undergo osteoporosis assessment. [BMC Prim Care 2025;26:150]

The odds of willingness to undergo osteoporosis assessment were lower among women of other ethnicities than those of Chinese ethnicity (odds ratio [OR], 0.457, 95 percent confidence interval [CI], 0.241–0.866; p=0.016) and were higher among women with vs without a history of fractures (OR, 2.660, 95 percent CI, 1.165–6.074; p=0.020).

Furthermore, the odds increased by 7.6 percent with each additional increase in age (OR, 1.076, 95 percent CI, 1.012–1.1431; p=0.019), by 26.2 percent for every additional increase in risk perception score (OR, 1.262, 95 percent CI, 1.133–1.4061; p<0.001), and by 26.9 percent for every additional increase in exercise benefit score (OR, 1.269, 95 percent CI, 1.094–1.473; p=0.002). 

Taken together, “these findings reflect an appropriate level of awareness regarding risk perception and preventive measures for osteoporosis,” which may be attributed to the work of advocate groups such as the Osteoporosis Society of Singapore, according to the investigators.

Indeed, in Singapore, Chinese women have been shown to have a 40-percent higher hip fracture rate compared with Malay women and a striking 90-percent higher hip fracture rate compared with Indian women. Meanwhile, women at least 66 years of age appear to have higher osteoporosis risk perception scores and higher perceived calcium benefits scores, consistent with those in Saudi Arabia and in Korea. [Osteoporos Int 2019;30:879-886; Nutrients 2023;15:3052; Osteoporos Int 2019;30:1395-1401]

“The findings highlight the need for continued education and awareness campaigns to promote osteoporosis assessment, particularly emphasizing the use of Osteoporosis Self-Assessment Tool for Asians (OSTA) as a tool for screening and assessing risk for osteoporosis,” the investigators said.

“[Additionally,] healthcare providers may consider leveraging this increased risk perception as a potential avenue for promoting osteoporosis assessment and prevention among at-risk women with a family history of the condition,” they added.

The investigators emphasized the importance of osteoporosis assessment and prevention given that the medical condition may increase the risk of fractures, which in turn are a major cause of pain, disability, and reduced quality of life, contributing to significant morbidity and mortality.

“Knowledge of the factors [that influence willingness to undergo osteoporosis assessment] will be useful when developing interventions to improve preventive behaviours and increase uptake of osteoporosis assessment for those at risk,” they said.

A total of 342 women (mean age 62.29 years, mean BMI 24.7 kg/m², 75.3 percent Chinese, 85.3 percent married) participated in the study. Of the participants, 6.7 percent had experienced falls in the past 6 months, 15.8 percent had a history of fractures, and 15.2 percent had a family history of osteoporosis. Roughly two-thirds of participants (66.1 percent) were willing to undergo osteoporosis assessment, and 10.9 percent of participants were at high risk of osteoporosis based on OSTA.