Calcium Supplement and Bone Medication Use in a US Medicare Health Maintenance Organization

This study was conducted to determine the prevalence of the use of calcium supplements and of prescription medications to prevent or treat osteoporosis in men and women in a large New England Medicare Health Maintenance Organization (HMO). A two-page diet, medication use and medical history questionnaire was sent to a random sample of 9000 out of 82 985 members and 2932 (32.6%) responded. Over 97% of the participants were Caucasian and 64.7% were female. The mean ages of the men and women were 74.4 ± 5.8 and 74.6 ± 6.2 years, respectively. Sixty-nine percent of the men and 59% of the women consumed two or fewer servings of dairy foods per day. Calcium supplement use was more prevalent among the women than the men (66.8% vs 24.9%, p<0.001). Men and women with higher dairy food intakes were more likely to take calcium supplements than were those with lower dairy intakes. Prescription bone medications (including bisphosphonates, raloxifene and calcitonin) were used currently by 17.5% of the women and 2.3% of the men (p<0.001). An additional 16.2% of the women currently took estrogen. Among the women, bone medication use did not change with age but estrogen use declined with increasing age. Among women age 80+ years, 15.6% used bone medications and 4.9% took estrogen. According to a national survey, more than half the US Caucasian female population over age 80 years has bone density low enough to warrant treatment under current guidelines. Based on the results of this survey, many elderly men and women may benefit from increased utilization of calcium supplements and bone-active medications.