Osteoporosis - A Short Summary
Risk factors for Osteoporotic Fracture
(The four items in boldface type are key factors in determining risk of hip fracture independent of BMD)
Nonmodifiable
- Personal history of fracture as an adult
- History of fracture in first-degree relative
- Caucasian/Asian race
- Advanced age
- Female sex
- Dementia
- Poor health/frailty
Potentially modifiable
- Current cigarette smoking
- Low body weight (<127 lbs)
- Estrogen deficiency: early menopause (before age 45) or bilateral ovariectomy or prolonged premenopausal amenorrhea (>1 year)
- Low calcium intake (lifelong)
- Alcoholism
- Impaired eyesight despite adequate correction
- Recurrent falls
- Inadequate physical activity
- Poor health/frailty
Who Should Be Tested?
- All women age 65 and over
- All postmenopausal women under age 65 with risk factors (besides menopause)
- Postmenopausal women with fractures
- Women who are considering therapy for osteoporosis, if BMD testing would facilitate the decision
- Women who have been on HRT for prolonged periods
Who Should Be Treated?
| BMD T-Score | ACTION |
| Below -2.0 in absence of risk factors | Initiate therapy |
| Below -1.5 if other risk factors are present | Initiate therapy |
Women over age 70 with multiple risk factors
(especially those with previous nonhip, nonspine fractures) | Initiate therapy |
As part of any pharmacologic treatment program for osteoporosis, patients should be specifically counseled on the importance of calcium, vitamin D, and exercise.
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