Osteoporosis Risk Score Calculator

How does this osteoporosis risk score calculator work?

This health tool evaluates osteoporosis risk based on individual factors that are weighted separately in a study based formula. The result is then stratified according to three risk groups.

The following table explains the weighting method in the Osteoporosis risk score calculator:

The formula that employs the discrete values from the table above is:

SCORE = Race + Rheumatoid Arthritis + Fracture history + Estrogen + (3 x Age / 10) - (Weight in lbs / 10)

The SCORE was developed after the study conducted by Lydick and colleagues as a stratification tool for post-menopausal women at risk of osteoporosis (consistent with BMD T scores <-2). It allows clinicians to underline the relationship between low bone mass and fracture risk.

Bone density test (bone densitometry) remains the main diagnosis method but cannot be applied efficiently as mass screening method, therefore the SCORE tools comes as a great first step substitute for a wide range of patients, those scoring high being then sent for further testing.

The test sensitivity was established during one of the validation studies to be 91% and the specificity 40%.

Osteoporosis risk guidelines

This is a condition that causes bone structure to weaken to such brittleness that falls or mild stresses can cause fractures, most commonly of the wrist, hip or spine.

Early stages don’t carry significant symptoms, however progression might be signaled by back pain, loss of height in time, bone fractures.

Some of the unchangeable risk factors for osteoporosis are:

■ Gender – women are more likely to develop the condition;

■ Age – the higher the age, the higher the risk;

■ Race – white and Asian populations have higher rates of osteoporosis;

■ Body frame – smaller body frames with lower weights are more predisposed;

■ Family history – of fractures, especially hip.

Other risk factors that may be controlled and altered to some extent include:

■ Steroid medication – this interferes with bone processes;

■ Hormone levels – for example estrogen reduction in menopausal women or overproduction of thyroid hormone;

■ Lifestyle – sedentary life without exercise, smoking or drinking have been shown to contribute to the weakening of the bones;

■ Nutrition – low calcium intake or eating disorders that reduce food intake.

Patients presenting relevant risk factors may be referred for a bone density test which measures the density of bones and can predict sensibly risk of future fractures. It comprises of a dual-energy x-ray absorptiometry scan of the hip and spine and the result comes as a T-score.

The score statistically compares the result of the test with standard measurement of a healthy thirty-year-old of same gender and race:

■ T-score of -1.0 or higher – indicates normal bone status;

■ T-score between -1.0 and -2.5 indicates osteopenia;

■ T-score of -2.5 and below are consistent with osteoporosis.

References

1) Lydick E, Cook K, Turpin J, Melton M, Stine R, Byrnes C. (1998) Development and validation of a simple questionnaire to facilitate identification of women likely to have low bone density. J Manag Care; 4(1):37-48.

2) Geusens P, Hochberg MC, van der Voort DJ, Pols H, van der Klift M, Siris E, Melton ME, Turpin J, Byrnes C, Ross P. (2002) Performance of risk indices for identifying low bone density in postmenopausal women. Mayo Clin Proc; 77(7):629-37.

3) Cadarette SM, Jaglal SB, Murray TM. (1999) Validation of the simple calculated osteoporosis risk estimation (SCORE) for patient selection for bone densitometry. Osteoporos Int; 10(1):85-90.

4) Sedrinea WB, DevogelaercJP, KaufmandJM, Goemaered S, Depresseuxc G, Zegels B, Deroisye R, Reginstera JY. Evaluation of the simple calculated osteoporosis risk estimation (SCORE) in a sample of white women from Belgium. Bone; 29(4):374-380.