Doctors Gain Tools to Predict Broken Hips
Data will determine who needs aggressive preventive therapy

(HealthDay News) -- Doctors may have a new tool to predict just which women are likely to break a hip.

Overall, women are more apt than men to sustain a hip fracture as they age, but some women have a greater likelihood of fracture than others. Experts say that determining an individual woman's risk might encourage women at risk to take preventive action.

To that end, researchers have developed a new algorithm to predict the risk of fracture over a five-year period.

"This gives us a way to pinpoint which women need aggressive preventive therapy," Paul Brandt, an associate professor of neuroscience and experimental therapeutics at Texas A&M Health Science Center College of Medicine, told HealthDay .

According to the American Academy of Orthopaedic Surgeons, more than 352,000 hips are broken in the United States each year -- a number that is expected to swell to 650,000 annually by 2050. Nearly all hip fractures -- 90 percent -- are due to falls, the academy notes.

Women incur two to three times as many hip fractures as men, it reports. And studies have found that white, postmenopausal women have a one in seven chance of a hip fracture during their lifetime, the academy states.

Hip fractures, often caused by osteoporosis, are serious injuries with potentially dire complications. About one in five people die within a year, reports the U.S. Centers for Disease Control and Prevention. Of those who lived independently before their injury, one in four requires nursing home care for at least a year afterwards, the CDC adds.

Yet 95 percent of those who sustain an osteoporotic fracture are never evaluated or treated for the disease, according to the National Osteoporosis Foundation.

To help identify women at risk, a research team led by Dr. John Robbins, a professor of internal medicine at the University of California-Davis, School of Medicine, used data from nearly 100,000 women who participated in the federal government's Women's Health Initiative.

The predictive model is based on 11 different factors, including age, self-reported health, weight, height, race/ethnicity, self-reported physical activity, history of fracture after age 54, parental history of hip fracture, current smoking, current corticosteroid use and treated diabetes.

Separately, in 2008, the World Health Organization released its own algorithm for predicting bone fracture caused by low bone mass or osteoporosis. The Web-based tool, called FRAX, predicts the 10-year fracture risk in men and women.

Armed with tools such as these, clinicians may be better equipped to ensure that high-risk individuals get appropriate treatment.

And although some risk factors for thinning bones, such as age and gender, cannot be altered, the International Osteoporosis Foundation encourages people to make healthy lifestyle changes to minimize their risk.

To prevent thinning bones, the National Osteoporosis Foundation recommends that everyone:

• Get the daily recommended amounts of calcium and vitamin D.
• Engage in regular weight-bearing and muscle-strengthening exercise.
• Avoid smoking and excessive alcohol.
• Talk to their health care provider about bone health.
• Have a bone density test and take medication when appropriate.

On the Web

To learn whether your bone health is at risk, take a one-minute test offered online by the International Osteoporosis Foundation.

SOURCES: HealthDay News ; Paul Brandt, Ph.D., associate professor, neuroscience and experimental therapeutics, Texas A&M Health Science Center College of Medicine, College Station, Texas; Nov. 28, 2007, Journal of the American Medical Association ; American Academy of Orthopaedic Surgeons (www.aaos.org); Centers for Disease Control and Prevention (www.cdc.gov); International Osteoporosis Foundation, Nyon, Switzerland; National Osteoporosis Foundation (www.nof.org)
Author: Karen Pallarito
Publication Date: Nov. 30, 2008
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