Women
Age range chart
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0-9 |
10-14 |
15-19 |
20-24 |
25-29 |
30-34 |
35-39 |
40-44 |
45-49 |
50-54 |
55-59 |
60-64 |
65-69 |
70-79 |
>80 |
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Men
Age range chart
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0-9 |
10-14 |
15-19 |
20-24 |
25-29 |
30-34 |
35-39 |
40-44 |
45-49 |
50-54 |
55-59 |
60-64 |
65-69 |
70-79 |
>80 |
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The goal of the prevention and treatment of osteoporosis is to reduce a person’s overall fracture risk, not just to maintain bone density.
Review of fracture risk factors for postmenopausal women aged >45 years and men aged >50 years is recommended (Practice Point). Those with increased risk should have bone density assessed (Practice Point).
Osteoporosis is a disease characterised by low bone mass and micro-architectural deterioration of bone tissue, leading to bone fragility and increased fracture risk.1 It is diagnosed on the presence of a fragility fracture (fracture from the equivalent of a fall from standing height or less, or a fracture that under normal circumstances would not be expected in a healthy young man or woman). For epidemiological and clinical purposes, osteoporosis is defined by bone mineral density (BMD) as a T-score of ≤–2.5. However, age, lifestyle factors, family history, and some medications and diseases contribute to bone loss and increased risk of fragility fractures. Furthermore, it is important to note that in an individual who has sustained a fragility fracture, a T-score of ≤–2.5 is not also required to make the diagnosis of osteoporosis, the presence of a fragile fracture is sufficient. Thus, the goal of prevention and treatment is to reduce a person’s overall fracture risk (not just maintain bone density).
Two of the most widely validated methods to estimate absolute fracture risk for osteoporotic fractures relevant to the Australian population are available at:
These calculators can be used with and without measuring BMD, though the Garvan fracture risk calculator has not been validated in an external cohort when BMD has not been used in the calculator.2 Risk estimation is imperfect, with the tools being modest predictors of fracture risk.3,4 Risk factors (eg falls, glucocorticoid use) not included in one or the other risk algorithm require clinical judgement to modify the risk estimate.
To date, there are no randomised controlled trials (RCTs) directly evaluating screening effectiveness, harms and intervals, and whether screening is performed by bone density screening by dual-energy X-ray absorptiometry (DXA) or by estimating absolute fracture risk.4 The place of absolute fracture risk assessment in the prevention and management of osteoporosis requires further clarification as its effectiveness is yet to be tested.