Age, Bone Mass Predict Fracture Risk
Study of Postmenopausal Women Shows Depression May Also Be a Risk Factor
Nov. 14, 2006 (Washington, D.C.) -- Age and low bone mass continue to be
major predictors of fractures in postmenopausal women, according to a study of
more than 170,000 women presented at the annual meeting of the American College
of Rheumatology in Washington, D.C.
More than 1.5 million fractures a year result from osteoporosis, a disease that causes bones to thin
and become brittle, according to the National Osteoporosis Foundation, based in
The new study, dubbed the National Osteoporosis Risk Assessment Study
(NORA), confirms that previously identified risk factors -- a history of
fracture, low bone mass, advancing age, poor health, and others -- remain the
biggest predictors of fracture risk, says a study author, Ethel S. Siris,
Onus on Women
"A wide array of risk factors are important for women and they need to
talk to their doctor about receiving a bone mineral density test and what else
they should be doing to minimize their risk of fracture," says Siris, the
Madeline C. Stabile Professor of Clinical Medicine and the director of the Toni
Stabile Osteoporosis Center at Columbia University Medical Center in New York
"This kind of information will help women open a conversation with their
doctors about their personal risk factors for fractures," Siris tells
"Patients have to be proactive," she tells WebMD. "We know in
the U.S. that osteoporosis is a major public health issue in older women, but
there is a gap between what we should be doing and what we are doing."
While prescription medications play a role in reducing fracture risk,
adequate calcium and vitamin D consumption, as well as strategies to protect
against falls, are also important, Siris says.
Of the 170,314 women who completed surveys at one, two, and five years,
7,989 reported a fracture.
The study included postmenopausal women 50 or older who had no previous
diagnosis of osteoporosis and were not taking medication for
In the study, women over 65 were more likely to sustain a fracture than 50-
to 64-year-olds; those 85 and up were even more likely.
There was a 12% increased risk for 65- to 69-year-olds and a double risk for
those 85 and up, when compared with the 50- to 64-year-olds.
History of fracture, low bone mass (as in osteoporosis), and poor to fair
self-rated health topped the list of risk factors.
Women who reported they were in poor/fair health had a 71% increased risk
compared with women who claimed to be in excellent health.
In addition, black and Asian women had a lower risk for fracture than white
Asian women typically have greater risk of fracture, but Siris speculates
these women experienced "silent" spine fractures, and as a result did
not report them.
Self-reported loss of height was a risk factor for fractures as well, the
Women with symptoms of depression also showed an increased risk for
fracture compared with non-depressed women, according to the new data.
"People with depression probably have a variety of physical
problems," Siris speculates. "They may not eat well or sleep well,
which could affect their overall health and fracture risk, but we don't know
for sure how depression relates to fracture risk."