Harvard Women's Health Watch

In Brief: "No-bones" calculator can help predict hip fracture risk

In Brief

"No-bones" calculator can help predict hip fracture risk

A new risk calculator developed by researchers from the Women's Health Initiative (WHI) assesses a woman's risk of breaking a hip in the next five years. And it does so without considering bone density.

Bone density, as measured by dual energy x-ray absorptiometry (DEXA), is still the single most reliable indicator of a woman's risk of osteoporosis and hip fracture. But there's more to hip fracture risk than bone density. The WHI risk calculator — in the form of an online questionnaire — identifies 11 factors that, taken together, may predict hip fractures more accurately than bone density alone.

The importance of these risk factors emerged in the 1990s from a number of investigations — particularly the French EPIDOS (Epidémiologie de l'ostéoporose) study and, in the United States, the Study of Osteoporotic Fractures (SOF). EPIDOS included about 7,600 women ages 75 and over, and SOF involved nearly 8,000 women over age 65. In each study, women underwent DEXA testing and physical examinations and were interviewed about their lifestyles. Both studies found that fewer than half of the women who broke a hip had DEXA scans suggesting osteoporosis.

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