What does this tool measure?

This tool measures the risk for developing thin and brittle bones (osteoporosis) in women age 45 and older. It is based on information from the Osteoporosis Risk Assessment Instrument.¹

This tool is for most women age 45 and older. The results may not be accurate for women who have serious health problems. And it may not be accurate for women who have taken medicines such as corticosteroids for a long time.

The answers you choose in the tool are related to four of the major risk factors for osteoporosis. They are:

• Being a woman. Men have a much lower risk than women do.
• Being older than 65.
• Having a thin body build.
• Not taking estrogen. Estrogen (alone or in combination with progesterone) slows bone thinning and causes some increase in bone thickness. There are risks to taking estrogen, but it may be used to prevent or slow bone loss in women who are at risk or have osteoporosis.

Other risk factors that affect both men and women include:

• Personal or family history of easily or unexplained broken bones.
• Use of medicines that may cause osteoporosis, such as steroids or too much thyroid medicine.
• For women, early menopause, which may be caused by ovaries not working properly or by surgical removal of the ovaries.
• Family history (mother, father, or sibling) of osteoporosis.
• Smoking.
• Frequent use of alcohol.
• Little or no weight-bearing exercise.
• A diet low in calcium and vitamin D.
• Hyperthyroidism or other conditions that make the body unable to absorb enough calcium.
• European or Asian ancestry.

What does your score mean?

Your score is based on your answers to questions about your gender, age, weight, and use of estrogen:²

• A high score (18 and over) means you are at risk for osteoporosis.
• A moderate score (9 to 17) means you may be at risk, based on those factors.
• A low score (8 and under) means that you do not appear to be at risk, based on those factors.

It's important to remember that there are other risk factors for osteoporosis and that having more than one risk factor means your risk may be higher. A woman who is younger than 45 may have risk factors for osteoporosis that are not measured by this tool.

What's next?

If you are concerned about your results, talk to your doctor. A diagnosis of osteoporosis is based on your medical history, a physical exam, and a test to measure your bone thickness (density). The most accurate test is called a DEXA scan.

The United States Preventive Services Task Force (USPSTF) recommends that all women age 65 and older have a bone density test. If you are at increased risk for broken bones caused by osteoporosis, you should start routine screening sooner.³ USPSTF recommends that you and your doctor check your fracture risk using a tool such as FRAX to help decide whether you should be screened for osteoporosis. Talk to your doctor about your risk factors and about when to start bone mineral density screening.

The FRAX tool was developed by the World Health Organization to help predict your risk of having a fracture related to osteoporosis in the next 10 years. You can use this tool too. Go to the website at www.sheffield.ac.uk/FRAX, and click on Calculation Tool. If you have had a bone mineral density test (BMD) on your hip, you can type in your score. If you have not had that test, you can leave the score blank.

For help deciding if and when testing is right for you, see the topic:

Osteoporosis: Should I Have a Dual X-Ray Absorptiometry (DEXA) Test?

Getting regular exercise and eating a diet that has enough calcium and vitamin D can reduce your chances of severe bone thinning. For more information, see the topic Osteoporosis.

Source: Cadarette SM, et al. (2000). Development and validation of the osteoporosis risk assessment instrument to facilitate selection of women for bone densitometry. Canadian Medical Association Journal, 162(9): 1289-1294.

Source: Cadarette SM, et al. (2004). The validity of decision rules for selecting women with primary osteoporosis for bone mineral density testing. Osteoporosis International, 15: 361-366.