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A study of 93,000 women identified ten risk factors for hip fracture, with old age at the top of the list. There's a huge industry diagnosing and treating osteoporosis - bone thinning with ageing. But the main reason for being concerned about osteoporosis is that it increases the risk of bone fractures - especially of the hip - which can bring on premature death. And ironically many people who have hip fractures aren't necessarily osteoporotic on testing. So a follow-up study of 93,000 women aged 50 - 79 looked for what might predict - not the risk of osteoporosis - but the chances of actually having a hip fracture over a five year period. Not surprisingly, age was the most important factor; the older they were the higher their risk. Ten other factors though made the prediction more accurate. The worse women felt their health to be the higher the risk of a hip fracture, the taller and the thinner the greater the chances, plus smoking, being white, physical inactivity, a history of fracture after the age of 54, or hip fracture in a parent, being treated with steroids and being treated for diabetes. The results from a point scoring system related to these factors seemed to be as good a predictor as an osteoporosis bone scan. The trouble is that most trials to prevent hip fractures have been in people with osteoporosis. So the unanswered question is what treatment will work in people who have just a high fracture risk.
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