An assessment tool for predicting fracture risk in postmenopausal women

Due to the magnitude of the morbidity and mortality associated with untreat ed osteoporosis, it is essential that high-risk individuals be identified s o that they can receive appropriate evaluation and treatment. The objective of this investigation was to develop a simple clinical assessment tool bas ed on a small number of risk factors that could be used by women or their c linicians to assess their risk of fractures. Using data from the Study of O steoporotic Fractures (SOF), a total of 7782 women age 65 years and older w ith bone mineral density (BMD) measurements and baseline risk factors were included in the analysis. A model with and without BMD T-scores was develop ed by identifying variables that could be easily assessed in either clinica l practice or by self-administration. The assessment tool, called the FRACT URE Index, is comprised of a set of seven variables that include age, BMD T -score, fracture after age 50 years, maternal hip fracture after age 50, we ight less than or equal to 125 pounds (57 kg), smoking status, and use of a rms to stand up from a chair. The FRACTURE Index was shown to be predictive of hip fracture, as well as vertebral and nonvertebral fractures. In addit ion, this index was validated using the EPIDOS fracture study. The FRACTURE Index can be used either with or without BMD testing by older post-menopau sal women or their clinicians to assess the 5-year risk of hip and other os teoporotic fractures, and could be useful in helping to determine the need for farther evaluation and treatment of these women.