European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
Osteoporosis-related knowledge in a German adult population: determinants and translational implications for fragility fracture prevention.
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Hauser Anna-Lena, Noriega Urena Javier-Fernando, Lange Tobias, Gerstmeyer Julius Robert, von Glinski Alexander, Schulte Tobias L
Аннотация
PURPOSE: Osteoporosis is highly prevalent and a major cause of fragility fractures, particularly of the spine. Adequate patient knowledge is essential for prevention, early diagnosis, and treatment adherence. This study aimed to assess osteoporosis-related knowledge in an adult population and to identify demographic and clinical factors associated with knowledge levels.
METHODS: A cross-sectional online survey was conducted within a German patient panel. Adults (≥ 18 years) who provided electronic consent were included. Osteoporosis knowledge was assessed using the validated Osteoporosis Knowledge Assessment Tool (OKAT) and Facts on Osteoporosis Quiz (FOOQ). Osteoporosis risk was descriptively evaluated using the IOF One-Minute Osteoporosis Risk Test. Participants were stratified into three age groups (< 50, 50-65, > 65 years). Group comparisons were performed using Mann-Whitney U tests; associations were analyzed using Spearman correlations. Additionally, multivariable linear regression analyses were performed.
RESULTS: A total of 315 participants were included (mean age 61.6 ± 12.0 years; 74.3% female). IOF risk scores increased significantly with age. Bivariate analyses demonstrated significantly higher knowledge in participants < 50 years compared to older groups, but this age association was no longer observed after multivariable adjustment. Women scored higher than men on the FOOQ but not on the OKAT. Higher educational attainment and employment in the medical field were significantly associated with higher knowledge scores. Neither personal diagnosis nor family history of osteoporosis was associated with increased knowledge. IOF risk scores showed a weak negative correlation with FOOQ scores.
CONCLUSION: Educational level emerged as an important correlate of osteoporosis knowledge in this exploratory analysis, whereas personal or familial disease experience did not improve understanding. These findings highlight a relevant gap in osteoporosis education and support the need for future targeted educational interventions, including in patient populations at risk for vertebral fragility fractures.
METHODS: A cross-sectional online survey was conducted within a German patient panel. Adults (≥ 18 years) who provided electronic consent were included. Osteoporosis knowledge was assessed using the validated Osteoporosis Knowledge Assessment Tool (OKAT) and Facts on Osteoporosis Quiz (FOOQ). Osteoporosis risk was descriptively evaluated using the IOF One-Minute Osteoporosis Risk Test. Participants were stratified into three age groups (< 50, 50-65, > 65 years). Group comparisons were performed using Mann-Whitney U tests; associations were analyzed using Spearman correlations. Additionally, multivariable linear regression analyses were performed.
RESULTS: A total of 315 participants were included (mean age 61.6 ± 12.0 years; 74.3% female). IOF risk scores increased significantly with age. Bivariate analyses demonstrated significantly higher knowledge in participants < 50 years compared to older groups, but this age association was no longer observed after multivariable adjustment. Women scored higher than men on the FOOQ but not on the OKAT. Higher educational attainment and employment in the medical field were significantly associated with higher knowledge scores. Neither personal diagnosis nor family history of osteoporosis was associated with increased knowledge. IOF risk scores showed a weak negative correlation with FOOQ scores.
CONCLUSION: Educational level emerged as an important correlate of osteoporosis knowledge in this exploratory analysis, whereas personal or familial disease experience did not improve understanding. These findings highlight a relevant gap in osteoporosis education and support the need for future targeted educational interventions, including in patient populations at risk for vertebral fragility fractures.