Guest Author - Tammy Elizabeth Southin
Osteoporosis is a serious condition affecting aging women during the postmenopausal years. Thinning bone density is preventable; the devastating effects can be minimized. Doctors are using the FRAX® measurement tool to discover which patients are at the greatest risk of developing osteoporosis. This simple test helps patients find ways to improve their bone health.
WHO and FRAX®
Designed by the World Health Organization (WHO), FRAX® is a diagnostic tool using a series of questions to determine a patient’s 10-year probability of having a major bone fracture. A major bone fracture involves one of the hip, spine, forearm, or shoulder.
Unlike bone density screenings or x-rays, this questionnaire bases its results on an individual’s health history. FRAX® has been adapted for various regions and countries of the world rather than relying on a homogenous approach. In North America, the model has been further broken down to address Canadian, African-American, Caucasian-American, Hispanic-American, and Asian-American populations.
The FRAX® tool is available in the following languages:
Arabic | English | Chinese Simplified | Chinese Traditional | Czech | Danish | Finnish | French | German Japanese | Korean | Polish | Russian | Spanish | Swedish | Turkish
How does FRAX® work?
The FRAX® tool looks at several risk factors and requires either a numbered answer as in a patient’s age, or a simple yes or no response.
*Age: The FRAX® model works with an age range of 40 to 90.
*Gender: This test applied to both men and women
*History of previous bone fractures in the patient
*Previous hip fractures in either of the patient’s parents
*Current smoking habits
*Current use of glucocorticoids, which are a class of steroid hormones
*Rheumatoid arthritis history
*Secondary factors that may lead to osteoporosis including type-1 diabetes, premature menopause, chronic liver disease
* Current alcohol consumption
*Bone mineral density
FRAX® is helpful but not absolute
The FRAX® tool is useful when combined with bone density screenings for a better picture of a patient’s bone health. But this calculator does have some limitations that prevent it from being the perfect diagnostic tool, as FRAX® assumes that all risk factors work through bone density alone. Other cautions include:
*The age range is from 40 to 90 and excludes many younger patients who must default to using 40 while very elderly patients must resort to using 90
FRAX® only considers current smoking history on the day of the test and disregards any prior smoking habits both in terms of how long and how heavy
*The fracture history excludes those of the face, fingers, and toes, which may be minor but can still indicated bone health disorders in some patients
*Steroid and alcohol intake is measured on in terms of less than three units per day; often patients underestimate what a unit is and may be drinking more-depending on size, a ‘glass’ of wine can range from three ounces up to six or seven ounces
*The bone density measurement only examines the femur or thighbone, also called the femoral neck
*FRAX® is currently only used on patients who are not being treated for low bone density or osteoporosis, as the medications taken will affect the test outcomes in terms of bone density measurements
*FRAX® does not take into account conditions such as epilepsy, cardio obstructive pulmonary disease, depression, and patients immobilized or bed-ridden
For its limitations, FRAX® does give doctors a measured, quantitative diagnosis to identify those patients most at risk for osteoporosis and bone fractures. One fall can have serious health consequences. FRAX® will continue to evolve into one of the most useful tools to help prevent the devastating effects of a bone fracture.
You and your doctor can access the FRAX® calculator at http://www.shef.ac.uk/FRAX®/index.jsp
Be sure to include your results in Menopause, Your Doctor, and You and keep your health history current!