Assessment of Osteoporotic Fracture Risk in Patients above 50 Years Using Quantitative Ultrasonography and Fracture Risk Assessment Tool: A Cross-sectional Study

Fracture risk prediction based on multivariable diagnostic models incorporating dual-energy X-ray absorptiometry based bone mineral density, trabecular bone score, and clinical risk factors in women aged ≥ 50 years: a prospective study

Indirect bone microarchitecture analysis using DXA-derived TBS predicts fragility fracture risk independently of spine BMD and with comparable predictive performance in postmenopausal women in Poland.

Prevalence of densitometric osteoporosis in women younger than 65 years without indications for DXA screening

Osteoporosis is the most prevalent metabolic bone disease and is associated with an increased risk of fragility fractures. Current guidelines recommend bone mineral density (BMD) assessment by DXA primarily in women aged ≥65 years or in younger women with clinical risk factors. However, DXA is frequently performed in women under 65 years without guideline-based indications. Objective: To describe the prevalence of densitometric osteoporosis in women under 65 years undergoing DXA in the absence of clinical risk factors. Methods: A descriptive cross-sectional study was conducted at a referral center. Women aged 40–65 years consecutively referred for DXA between February and September 2024 were included. Participants with FRAX® clinical risk factors, major osteoporotic fractures, secondary metabolic bone diseases, or dietary restrictions were excluded. BMD was assessed at the lumbar spine, total hip, and femoral neck. Osteoporosis was defined as a T-score ≤ -2.5. Results: A total of 119 women were included (mean age 53 years; range 43-62). Mean T-scores were -0.9±1.3 at the lumbar spine, -0.9±1.1 at the total hip, and -1.0±1.0 at the femoral neck. BMD values within the osteoporotic range was observed in 13% (n=15) at the lumbar spine and in 7% (n=8) at both the total hip and femoral neck. Overall, 17% (n=20) had BMD values within the osteoporotic range at at least one skeletal site. Conclusion: Densitometric osteoporosis was identified in a relevant proportion of women younger than 65 years without traditional risk factors, supporting an individualized approach to bone health assessment.

Prevalence and Risk Factors of Osteoporotic Fractures Among Older Adults

Background: Osteoporotic fractures are a major public health concern among older adults, leading to significant morbidity, mortality, and reduced quality of life. Identifying prevalence and risk factors is critical for effective prevention. Aim: To determine the prevalence of osteoporotic fractures among older adults and evaluate associated risk factors. Methodology: A prospective observational study was conducted at the Department of Orthopaedics, Sheikh Bhikhari Medical College and Hospital, Hazaribagh, Jharkhand, India, from May 2022 to August 2024. Ninety adults aged ≥60 years with clinically and radiologically confirmed osteoporotic fractures were enrolled. Demographic, clinical, and lifestyle data were collected, and fracture sites were documented. Bone mineral density assessment and structured questionnaires captured nutritional and lifestyle risk factors. Statistical analyses included Chi-square tests and multivariate logistic regression. Results: Hip fractures were most common (38.9%), followed by vertebral (27.8%) and distal radius (20%) fractures. Female sex predominated in hip and vertebral fractures (p<0.05). Significant independent risk factors included age ≥70 years (OR=2.45), female sex (OR=1.78), low calcium intake (OR=2.10), vitamin D deficiency (OR=1.92), sedentary lifestyle (OR=2.30), and history of previous fractures (OR=3.15). Smoking and alcohol use were not significantly associated. Conclusion: Osteoporotic fractures are prevalent among older adults, particularly in women and those with prior fractures or nutritional deficiencies. Targeted interventions, including nutritional supplementation, physical activity, and fall prevention, are essential to reduce fracture risk and improve quality of life.

Association of body composition with bone mineral density and fracture in diabetic elderly: Results from AHAP study.

Effecacy of a population-based screening program for osteoporosis and high fracture risk in primary healthcare

There is no unified approach to screening for high fracture risk in international practice. Objective : to evaluate the efficacy of a population-based screening program for osteoporosis and high fracture risk using the FRAX tool in postmenopausal women and men aged 40 years and older in real-world primary healthcare practice. Material and methods . A single-center prospective case-control cohort study included 34,357 individuals aged 40 years and older. In the screening group (n=10,743), primary care physicians assessed the 10-year probability of fractures using the FRAX calculator in 2018. High fracture risk was defined as exceeding the Russian FRAX intervention threshold and/or having a history of a low-energy fracture. The control group consisted of unscreened individuals (n=23,614). Screening efficacy was assessed based on changes in the incidence of osteoporotic fractures during 3 years of follow-up (2019–2021). Results and discussion . High fracture risk was identified in 16.8% of patients in the screening group. In this group, the incidence of all fractures decreased by 33.8% (from 21.0 to 13.9 per 1,000 population; p<0.001), whereas in the control group this indicator increased by 26.7% (from 8.6 to 10.9 per 1,000; p=0.012). In the subgroup of high-risk patients who received treatment, fracture incidence decreased 3.1-fold (p<0.001). Conclusion . Screening based on FRAX and a history of previous fractures is an effective strategy for reducing fracture rates in real-world clinical practice and may therefore be recommended for widespread use in primary healthcare.

Bone Health Index (BHI): a Fracture Risk Assessment tool in Children with Osteogenesis Imperfecta.

The study indicates that lower BHI SDS values are associated with increased fracture risk in children with classical OI and indicates that BHI may represent a clinically useful complementary tool for fracture risk stratification in young children with OI, particularly where DXA is unavailable or technically limited, including infancy.