Usefulness of the SCORE index as a predictor of osteoporosis in women with disabilities.

BACKGROUND

Osteoporosis is widely recognized as a common health problem among older women. It has also recently been identified as common in both pre- and postmenopausal women with disabilities. Although several clinical indices have been developed to identify nondisabled women likely to have low bone mineral density (BMD) when tested, studies that have tested the usefulness of these clinical indices have excluded women with disabilities. Thus, the usefulness of these indices in predicting low BMD and osteoporosis in women with disabilities is unknown.

PURPOSE: This study examined the ability of one of these indices, the Simple Calculated Osteoporosis Risk Estimation (SCORE), to identify women with disabilities likely to have low BMD on screening. SAMPLE/DATA COLLECTION: Women with disabilities (N = 307) responded to the six-item SCORE index and underwent peripheral BMD screening. The sensitivity, specificity, and accuracy of the SCORE index in predicting BMD with the criterion of a T-score of </=2.5 were 65.7, 61.1, and 62.2%, respectively. When a T-score of </=2.0 was used as the criterion, the sensitivity, specificity, and accuracy of the SCORE index were 62.6, 63, and 62.9%, respectively.

FINDINGS: The low sensitivity, specificity, and accuracy of the SCORE index indicate that it is not a useful predictor of low BMD in women with disabilities, incorrectly categorizing almost 40% of the sample. A clinical index that includes osteoporosis risk factors present in women with disabilities is needed to increase the likelihood that women with disabilities will be referred for testing and receive treatment of osteoporosis when indicated.