Osteoporosis: assessing the risk of fragility fracture

National Institute for Health and Care Excellence


Full list of recommendations

Targeting risk assessment

  • Consider assessment of fracture risk:
    • in all women aged 65 years and over and all men aged 75 years and over
    • in women aged under 65 years and men aged under 75 years in the presence of risk factors, for example:
      • previous fragility fracture
      • current use or frequent recent use of oral or systemic glucocorticoids
      • history of falls
      • family history of hip fracture
      • other causes of secondary osteoporosis*
      • low body mass index (BMI) (less than 18.5 kg/m2)
      • smoking
      • alcohol intake of more than 14 units per week for women and more than 21 units per week for men
  • Do not routinely assess fracture risk in people aged under 50 years unless they have major risk factors (for example, current or frequent recent use of oral or systemic glucocorticoids, untreated premature menopause or previous fragility fracture), because they are unlikely to be at high risk
  • Estimate absolute risk when assessing risk of fracture (for example, the predicted risk of major osteoporotic or hip fracture over 10 years, expressed as a percentage)

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