A Comparison of Prediction Models for Fractures in Older Women

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Abstract
Advanced age and low bone mineral density (BMD) are strongly associated with higher fracture risk in older women.1 Data from randomized trials support the recommendation to initiate pharmacologic therapy to lower fracture risk among older women with osteoporosis as defined by BMD T scores of −2.5 or less (at least 2.5 SDs below average for healthy young women). However, despite a lower risk of fracture, more fractures occur in the much larger group of older women without osteoporosis (BMD T scores above −2.5) in whom there is much less certainty about the efficacy of drug therapy.