Assessing absolute fracture risk is a critical component of therapeutic decision-making and should be a collaborative process with the patient. This risk can be calculated using tools such as FRAX® or the Garvan Fracture Risk Calculator. Both of these tools incorporate bone mineral density (BMD) as a risk factor, but they can also estimate risk in the absence of a BMD measurement.

Assessing fracture risk with tools like FRAX® or Garvan helps guide treatment decisions based on multiple known risk factors, even when BMD measurements are unavailable.

Common risk factors for osteoporosis are:

  • Being a woman aged 50 years and over and being a man aged 65 years and over
  • Low body weight (Body mass index less than 20 kg/m2)
  • A personal history of previous fragility fractures
  • A family history of fragility fracture and/or osteoporosis
  • Menopause (especially if before 45 years)
  • Smoking
  • Drinking more than 2 standard alcoholic drinks daily
  • A history of falls
  • Some medications used to treat other conditions such as chronic obstructive pulmonary disease (COPD), prostate cancer or breast cancer
  • Some medical conditions such as rheumatoid arthritis, diabetes or dementia
  • Undiagnosed conditions that affect absorption of nutrients, such as coeliac disease, or a history of eating disorders