Risk factor
|
Risk score
|
---|
Vertebral fracture
|
4
|
Recent fracture (<2 years) after the age of 50 years
|
4a
|
Age ≥ 70 years
|
1
|
Age ≥ 60 years
|
1
|
Non recent fracture after the age of 50 years
|
1
|
Additional non recent fracture after the age of 50 years at a separate occasion
|
1
|
Parental hip fracture
|
1
|
Body weight < 60 kg
|
1
|
Severe immobility or 1 fall or more in the last year
|
1
|
- Bone densitometry and morphological assessment of vertebral fractures (unless a vertebral x-ray has already been performed) is indicated if the total risk score is ≥4 points. Subsequently bisphosphonate treatment for 5 years is advised if the bone mineral density (BMD) of either femoral neck or lumbar spine shows a T-score ≤ −2.5 or if a prevalent vertebral fracture (≥25% height reduction) is presenta
-
aIn October 2012, when the trial had already started, the Dutch guidelines for GP’s for primary osteoporosis were updated [11]. In the previous guidelines, the treatment threshold of BMD (femoral neck or spine) was a T- score < −2.5 for patients aged <70 years, or a Z-score ≤ −1 for patients aged ≥70 years