Age-related change of total femur bone mineral density among US 6-80: National Health and Nutrition Examination Survey (NHANES) 2005-2020

Research Objectives: A bone mineral density (BMD) test measures the amount of bone minerals (mostly calcium and phosphorous) contained in a certain volume of bone. Low BMD is associated with an increased risk of fracture and is a predictor of frailty, pre-frailty, and osteoporosis in older people.

Design: This is an observational study.

Setting: General community.

Participants: Total femur BMD, taken from 28,514 noninstitutionalized participants, aged 6 to 80, were obtained from the National Health and Nutrition Examination Survey (NHANES) study. We described the age-related change of total femur BMD across the life span in four distinct cross-sectional surveys during 2005-2008, 2009-2012, 2013-2016, and 2017-2020, and compared the total femur BMD by sex, survey year, race/ethnicity, education, poverty level, and history of ever served on active duty.

Interventions: N/A

Main Outcome Measures: Dual Energy X-ray Absorptiometry - Femur.

Results: The means of total femur BMD varied by sex and age. The means of total femur BMD were lower for younger children, gradually increased to reach a plateau in early adult life, peaked around 19 years old, and then gradually declined onwards. Males had a higher total femur BMD than females after puberty. The mean of total femur BMD in females was 90% of that of males in middle adult age and 82% of that of males 70-80+ years older. Being male, being non-Hispanic black, having a higher educational level, and having an income higher than the poverty level was associated with higher total femur BMD levels (p < 0.001). Between 2005 and 2020, stable trends in total femur BMD were observed (p = 0.977). While individuals who had served on active duty in the US armed forces had a slightly higher mean total femur BMD than those who did not, the difference was not significant (p=0.170).

Conclusions: Between 2005 and 2020, stable trends in total femur BMD values were observed among noninstitutionalized residents in the US. Targeted educational efforts are warranted to enhance knowledge of personal risk indicators.

Author(s) Disclosures: The authors declare no conflict of interest.