Fracture Risk

“Osteoporosis and resultant fractures of the spine, hip and other sites are important public health problems with significant individual and societal costs. The risk for osteoporotic fracture is based upon low bone density and the presence of one or more clinical risk factors (see Table 1). A history of fracture during adulthood or falls are important clinical factors in determining the risk of future fracture; however, age is the most influential risk factor, such that middle-aged adults with other risk factors are likely to be at low absolute fracture risk in the medium term. Using these clinical risk factors and BMD when available, fracture risk assessment tools (based upon data collected from large prospective observational studies) have been developed to estimate the 5–10 year probability of hip fracture and other fractures in untreated patients. Clinicians should be aware that fracture risk can also be estimated using the FRAX or Garvan tools without BMD data. Chronic glucocorticoid use is an established risk factor for osteoporosis, with studies showing that use of glucocorticoids leads to accelerated bone loss and an increased risk of fracture. Other drugs are increasingly recognized as potential causes of bone loss and fracture, particularly amongst predisposed individuals….”

See the following link for more on other drugs that can cause bone loss and fractures:

http://strontiumforbones.blogspot.com/2015/01/adverse-skeletal-effects-of-drugs.html

Table 1.  Clinical risk factors for fracture

Advancing age

Previous fracture during adulthood

History of a fall or falls in the past 12 months

Glucocorticoid therapy

Parental history of hip fracture

Low body weight

Current cigarette smoking

Excessive alcohol consumption

Medical diseases (e.g. rheumatoid arthritis, hyperparathyroidism, coeliac disease, hypogonadism)

This introduction and table appeared in “Adverse Skeletal Effects of Drugs – Beyond Glucocorticoids,” Susannah O'Sullivan, Andrew Grey, Clin Endocrinol. 2015; 82(1):12-22. 

http://www.medscape.com/viewarticle/837369?src=wnl_edit_tpal&uac=127701PY