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Bone Health

The Significance of other Risk Factors

The results of studies of women with osteoporotic fractures have led to the development of models of risk prediction, which include clinical risk factors other than low bone mass. A large, longitudinal study (the Study of Osteoporotic Fractures) of postmenopausal, Caucasian women with low bone density readings showed that clinical risk factors contribute significantly to overall fracture risk.

Clinical risk factors may include:

low body weight or body mass index
history of bone fracture as an adult (not related to severe trauma)
nutritional deficits
chronic use of certain medications like corticosteroids, anti-seizure medications, etc.
estrogen deficiency
physical inactivity
neurologic or gait (walking disturbance)
use of sedating medications (pain relievers or psychotropic medications)
excessive alcohol use (may cause sedation, poor nutrition)
cigarette smoking (present or a significant past history)
family history of osteoporosis
visual impairment

The study identified 14 clinical risk factors (in addition to the low bone density). It grouped individuals on the basis of how many additional risk factors they had – from 0 to 5 or more.

The study found the highest fracture rate (27.3 per 1,000 woman years) occurred in the individuals with at least five of these risk factors. Women with no additional risk factors had the lowest rate (2.6 per 1,000 woman years) of fracture among all study participants.