A new online calculator can help women over 50 gauge their bone health even if they haven’t had a bone scan.
The Women’s Health Initiative Hip Fracture Risk Calculator
was created from data gathered from 162,000 women who took part in the Women’s Health Initiative, or W.H.I., the largest-ever study of women’s health.
An estimated 329,000 hip fractures occur annually in the United States, and a person’s risk of dying increases by 15 percent to 20 percent in the year after a hip fracture occurs. Although bone scans can detect low bone density and osteoporosis, which puts a person at risk for fracture, most hip fractures occur in women who don’t have osteoporosis.
The calculator is based on an algorithm, published yesterday in the Journal of the American Medical Association, that shows 11 different factors that are useful in predicting a woman’s risk for hip fracture. Among the issues that matter the most are whether the woman’s parents suffered from a hip fracture at an early age, whether a woman has fractured a bone before the age of 54, if she is a smoker and whether she takes corticosteroids.
Lead author Dr. John Robbins, a professor at the University of California, Davis, School of Medicine, says that many women at risk, including African-American women or those who are overweight or have normal bone density, often aren’t screened for bone health because doctors assume they aren’t at risk for a fracture.
“Doctors have a hard time looking at multiple factors,'’ says Dr. Robbins. “They have a mindset that it’s a disease of thin, Caucasian women, and that’s not really true.'’
The calculator predicts a woman’s five-year risk of hip fracture. But just because a woman appears to be at high risk doesn’t mean she should take bone-building drugs, notes Dr. Robbins. Although bone-building drugs have been shown to improve bone density, there’s no evidence that a woman with normal bone density, but still at high fracture risk, would benefit from using the drugs.
Instead, women with normal bone density but at known fracture risk might be advised to consider calcium supplements, increase weight-bearing exercise, safety proof their homes to prevent accidental falls and learn techniques to improve balance.
Dr. Robbins says the risk calculator is simply a tool women can use to help make decisions about their health. “The people who will get the most out of it are the ones who will have risk factors that aren’t looked at by physicians,'’ he said. “We have lots of women at known risk and nobody pays attention.'’