Latent profiles and factors associated with self-management among older adults with osteoporosis: a cross-sectional study

Osteoporosis is a major health concern among older adults. Although self-management is an important component of osteoporosis care, the heterogeneity of self-management profiles remains insufficiently understood.This study aimed to identify self-management profiles and examine factors associated with profile membership. A cross-sectional study was conducted among 529 older adults with osteoporosis recruited from a tertiary hospital in Shanghai, China, using convenience sampling. Latent profile analysis (LPA) identified self-management profiles, followed by multinomial logistic regression to examine associated factors. Three distinct self-management profiles were identified: low and unbalanced self-management (47.8%), moderate but treatment-oriented self-management (31.5%), and high and well-balanced self-management (20.7%). Exercise management was consistently the weakest domain across all profiles.Self-efficacy was significantly associated with both the moderate and high profiles, although the direction differed.Compared with the low self-management profile, each one-point increase in self-efficacy score was associated with slightly lower odds of belonging to the moderate profile (OR = 0.981, 95% CI: 0.968–0.995, P = 0.012), but higher odds of belonging to the high profile (OR = 1.030, 95% CI: 1.010–1.051, P = 0.002). Compared with an income of ≤ 5,000 RMB, an income of 5,000–10,000 RMB was associated with higher odds of the moderate (OR = 2.377, 95% CI: 1.124–5.026, P = 0.023) and high profiles (OR = 3.034, 95% CI: 1.201–7.668, P = 0.019). An income of ≥ 10,000 RMB was associated with higher odds of the moderate profile (OR = 3.377, 95% CI: 1.483–7.692, P = 0.004), but not the high profile (OR = 2.354, 95% CI: 0.833–6.651, P = 0.106). Male sex was associated with lower odds of the high profile (OR = 0.252, 95% CI: 0.079–0.806, P = 0.020), while absence of low back pain was associated with higher odds (OR = 3.184, 95% CI: 1.479–6.851, P = 0.003). Obtaining osteoporosis-related information primarily from family or friends was associated with lower odds of the high profile (OR = 0.059, 95% CI: 0.004–0.989, P = 0.049). Osteoporosis knowledge, social support, and quality of life were not independently associated with profile membership. Self-management among older adults with osteoporosis is heterogeneous, with distinct profiles associated with self-efficacy, socioeconomic characteristics, sex, low back pain, and sources of osteoporosis-related information.Profile-specific assessment may inform individualized nursing strategies. Longitudinal and multicenter studies are needed to clarify temporal relationships between associated factors and self-management. Not applicable.