What is FRAX?

A tool developed by the World Health Organization that calculates an individual's real-life risk of suffering an osteoporosis-related fracture in the coming years, FRAX (Fracture Risk Assessment Tool) incorporates bone mineral density scores with other weighted risk factors to arrive at a percent probability that a person will break a hip, vertebra, forearm, or shoulder within 10 years. Risk factors used are age, sex, height, weight, previous fragility fracture as an adult, parental history of hip fracture, current smoking, alcohol use (three or more drinks per day), glucocorticoid use for more than three months, rheumatoid arthritis, and secondary osteoporosis.
 
The tool was developed for physicians to use to better identify high-risk individuals. If you've had a bone density test or if you think you might have an increased risk of osteoporosis, you may want to ask your physician about calculating your FRAX score. The tool is geared for doctors' use, but you can find it online.

In 2008, a World Health Organization (WHO) task force introduced FRAX, a risk assessment tool that incorporates a number of risk factors for osteoporosis besides bone density. The FRAX tool provides an estimate of the likelihood that you will suffer a hip or other major fracture in the next 10 years. Using this tool, the National Osteoporosis Foundation issued guidelines suggesting that clinicians consider treatment with a Food and Drug Administration (FDA)-approved drug for women who meet any of the following criteria:

• a history of hip or spine fracture.
• a T-score of less than -- 2.5 at the hip or spine.
• a T-score of -- 1.0 to -- 2.5 at the hip or spine (indicating low bone mass short of osteoporosis) together with a 10-year, FRAX-estimated risk of more than 20% for any major osteoporosis-related fracture or more than 3% for hip fracture.

If you fall into one of those categories, exercise and a diet rich in calcium and vitamin D alone won't provide sufficient bone protection. You may also need medication.