This community-based cross-sectional study aimed to estimate the proportion of adults aged 50 years and older with low bone status assessed by calcaneal quantitative ultrasound (QUS) and to examine factors associated with low bone status among screening attendees.
The investigation used a one-off community bone health screening programme and analysed cross-sectional data collected during that programme.
The screening was conducted in Kieu Phu, a rural commune of Hanoi with an approximate population of 60,900. The programme ran between October and December 2025. Participants were community-dwelling adults aged 50 years and older who attended the screening; 592 individuals were included in the analysis.
Participants had a mean age of 74.8 years (SD 7.7). Women comprised 58.4% of the sample.
The primary outcome, low bone status, was operationally defined as a calcaneal QUS T-score ≤ -2.5. Calcaneal QUS was the selected screening modality for bone status in this community programme.
The authors note that calcaneal QUS is not equivalent to dual-energy X-ray absorptiometry (DXA)-based diagnosis but can be used for early risk identification where DXA access is limited, provided screening is linked to accessible confirmatory assessment and referral.
Crude and adjusted odds ratios (ORs) were estimated using logistic regression to identify factors associated with low bone status. The analysis included adjustment for covariates reported in the study.
Among the 592 screening attendees, the average age was 74.8 years (SD 7.7) and 58.4% were female. Other participant-level characteristics reported in the study included body mass index categories and clinical conditions such as hypertension and diabetes mellitus; specific distributions beyond what is summarized here were reported in the source.
Overall, 355 of 592 participants had low bone status on calcaneal QUS, corresponding to 60.0% (95% CI 56.0% to 63.8%). This proportion reflects the study sample of screening attendees, not a probability-based estimate for the wider rural population.
In adjusted logistic regression models, female sex showed the strongest independent association with low bone status (adjusted OR 8.71, 95% CI 5.77 to 13.15).
Participants classified as underweight had higher odds of low bone status compared with those with a body mass index of 18.5–22.9 kg/m² (adjusted OR 2.11, 95% CI 1.15 to 3.87).
Age ≥70 years, education level, former occupation, main income source, high sodium intake, hypertension and diabetes mellitus were not independently associated with low bone status in the adjusted analyses reported.
Low bone status by calcaneal QUS was common among attendees of this rural community screening programme in northern Vietnam. The independent associations with female sex and underweight status suggest these subgroups had substantially higher odds of low bone status within the screened population.
Because the sample comprised screening attendees rather than a probability sample from the community, the reported 60% proportion should not be interpreted as a prevalence estimate for the wider rural population.
The authors highlight that while calcaneal QUS is not a substitute for DXA-based diagnosis, it may support early risk identification in settings where DXA is inaccessible. The value of QUS screening depends on linkage to confirmatory assessment (such as DXA when available) and pathways for referral and management.
Strengths of the study include use of a community screening programme to capture older adults in a rural setting and clear operational definition of low bone status using QUS T-scores. The analysis reported both crude and adjusted associations.
Key limitations reported in the source are that participants were screening attendees rather than a probability sample, limiting the ability to generalize the 60% figure to the broader rural population. Additionally, calcaneal QUS is not equivalent to DXA, the reference standard for osteoporosis diagnosis; the study cannot substitute QUS results for DXA-based diagnostic classification.
Other potential limitations or details not reported in the source should not be assumed.
Among adults aged 50 years and older attending a one-off community bone health screening in rural northern Vietnam, 60.0% had low bone status by calcaneal QUS. Female sex and underweight status were independently associated with low bone status. These findings may inform local screening priorities but are not population prevalence estimates and underscore the importance of linking QUS screening to confirmatory assessment and referral when DXA is limited.