Knowledge, attitude, and practice of osteoporosis and hip fracture in older Chinese adults

This study assessed the knowledge, attitude, and practices (KAP) regarding osteoporosis and hip fracture among older adults in Ningxia, China, to inform better prevention and management strategies through patient education and lifestyle changes. This cross-sectional study surveyed older adults at Ningxia Hui Autonomous Region People's Hospital (Sep 2022-Nov 2023) using a convenience sampling method, collecting demographic data and assessing KAP scores. Structural equation modeling (SEM) analyzed relationships between KAP and demographics. The analysis included 522 (99.4%) valid questionnaires. The mean knowledge, attitude, and practice scores were 22.66 ± 4.29 (/30, 75.53%), the mean attitude score was 43.13 ± 4.54 (/60, 71.88%), and the mean practice score was 57.15 ± 10.24 (/80, 71.44%), indicating sufficient knowledge, positive attitude, and proactive practice. In the SEM, knowledge was associated with income (β = 1.01, P < 0.001), frequency of fall prevention (β=-0.55, P < 0.001), residence (β = 0.97, P = 0.030), and falls in the past year (β = 0.76, P = 0.017). Attitude was associated with knowledge (β = 0.21, P < 0.001) and alcohol (β=-1.26, P < 0.001). Practice was associated with attitude (β = 1.09, P < 0.001), frequency of fall prevention (β=-1.86, P < 0.001), and use of anti-osteoporosis drugs (β = 2.63, P < 0.001). Older adults in Ningxia demonstrated generally good KAP toward osteoporosis and hip fracture; however, targeted educational interventions addressing specific knowledge gaps may help further improve preventive practices and support behavior change.