IOF Risk Check

Question 1

Are you aged 60 or older?

Yes

No

I am over 50

I am over 40

I am under 40

Older than 60?

The risk of osteoporosis increases with age. Even if you have no other clinical risk factors, if you are a woman aged 60 years or over, or a man aged 70 years or over, you should discuss bone health at your next check-up.

Question 2

Have you broken a bone after the age of 50?

Yes

No

Broken a bone after age 50?

If you've broken a bone after a minor fall (from standing height), it may be because of osteoporosis. One broken bone is a major risk factor for a new fracture, with the highest risk in the following two years.

Question 3

Are you underweight?

(BMI below 19) Calculate your BMI:

Your weight
Your height

in

BMI result:

Your replies suggest that you may have major risk factors for osteoporosis and fractures. We encourage you to ask for a bone health assessment and to discuss strategies to reduce your risk for osteoporosis-related fractures with your doctor.

Underweight?

A Body Mass Index (BMI) of less than 19 kg/m² (equivalent to 19 lbs/in²) is a risk factor for osteoporosis. Being underweight can lead to lower oestrogen levels in girls and women, similar to after menopause, which may contribute to the development of osteoporosis. At the same time, frail people are at higher risk of fracture.

Question 4

After the age of 40, have you lost more than 4 cm in height (ca. 1.5 inches)?

Yes

No

I do not know

Getting shorter?

Height loss of more than 4 cm (1.5 in) as an adult is often caused by spine fractures due to osteoporosis. Not all spine fractures are painful, which means that sometimes people don’t know they have them.

Question 5

Have either of your parents had a hip fracture?

Yes

No

Parental history?

If your parents had a hip fracture, you may be at higher risk of developing osteoporosis and having a fracture. If either of your parents had a stooped back or there is a strong family history of osteoporosis, this could also be a sign that you are at increased risk of developing osteoporosis.

Question 6

Do you have any of the following disorders?

Rheumatoid arthritis

Digestive tract diseases (inflammatory bowel disease (IBD), coeliac disease)

Prostate or breast cancer

Diabetes

Chronic kidney disease

Thyroid gland disorders (hyperthyroidism, hyperparathyroidism)

Lung disorder (chronic obstructive pulmonary disease (COPD))

Low testosterone (hypogonadism)

Early menopause, periods stopped, or ovaries removed
(low oestrogen levels due to hypogonadism)

Immobility

HIV

I do not know, but I will ask my doctor

None of the above

Disorders
linked to osteoporosis

Some medical disorders are linked to an increased risk of osteoporosis and fractures. This is known as secondary osteoporosis. Some conditions can also increase the risk of falling, which can lead to fractures.

Question 7

Have you been treated with any of the following medications?

Glucocorticoids, often known as “steroids”, used to treat inflammation in various disorders (e.g. prednisone)

Aromatase inhibitors used to treat breast cancer

Androgen deprivation therapy used to treat prostate cancer

Thiazolidinediones used to treat diabetes (e.g. pioglitazone)

Proton pump inhibitors used to treat ulcers and gastric reflux, also known as heart burn (e.g. omeprazole)

Immunosuppressants used after transplantation surgeries
(e.g. calmodulin/calcineurin phosphatase inhibitors)

Thyroid hormone treatment used to treat hypothyroidism
(L-Thyroxine)

Steroid hormones, often known as “sex hormones”, used to treat low testosterone or low oestrogen (e.g. medroxyprogesterone acetate, luteinising hormone releasing hormone or LHRH agonists)

Antidepressants used to treat depression, obsessive compulsive disorder etc. (e.g. selective serotonin reuptake inhibitors (SSRI) like fluoxetine, fluvoxamine and paroxetine)

Antipsychotics used to treat bipolar disorder (e.g. lithium)

Anticonvulsant or antiepileptic drugs used to treat seizures (e.g. phenobarbital, carbamazepine and phenytoin)

I do not know, but I will ask my doctor

None of the above

Medications linked to osteoporosis

Long-term use of certain treatments can increase bone loss, leading to an increased risk of fracture. Some treatments also increase the risk of falls, which can result in broken bones.

Question 8

Do you drink excessive amounts of alcohol (more than 3 units a day) and/or currently smoke?

Yes

No

Too much alcohol intake?

Drinking too much alcohol impacts negatively on bone health and can also lead to frequent falls, which increases the risk of fractures.

Smoker?

Whether you’re a current smoker, or have smoked in the past, you should be aware that smoking has a negative impact on bone health.