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New Tool Reassesses Osteoporosis Risk

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New Tool Reassesses Osteoporosis Risk

Your Health

New Tool Reassesses Osteoporosis Risk

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STEVE INSKEEP, host:

It's MORNING EDITION from NPR News. I'm Steve Inskeep.

RENEE MONTAGNE, host:

And I'm Renee Montagne.

Today in Your Health, a new way to calculate your long term risk of a hip fracture or other major breaks. It's an online tool created by the World Health Organization, and it combines lifestyle risks such as smoking and alcohol use with bone density readings and family history.

As NPR's Allison Aubrey reports, the new method is helping people make more informed decisions about whether to take osteoporosis drugs.

ALLISON AUBREY: If you're 65 and healthy, like Rosemarie Moenster, the results of a bone density scan, which may reveal the beginnings of osteoporosis, can really shake things up.

Ms. ROSEMARIE MOENSTER (Teacher): I had doctors telling me that this was such a terrible disease and I was so bad. So I had this picture of my bones like cottage cheese, you know, just kind of falling apart and that I'd be in a wheelchair.

AUBREY: All this anxiety was born of one number - a T score reading, which is a measure of your bone density compared to what's found in a normal young adult of the same sex. For Moenster, the number was low enough to justify treatment with osteoporosis drugs, and her doctors put her on two of them.

When one of the medicines led to complications, she stopped taking it and went to see a specialist named Nelson Watts at the University of Cincinnati. He's using the new risk fracture tool.

Dr. NELSON WATTS (University of Cincinnati): So what we'll do is we'll go through these risk factors and you can tell me if they apply to you.

Ms. MOENSTER: OK.

MIKKELSON: Watts and Moenster sit at the computer in his office as he reads off a series of questions.

Dr. WATTS: So have you had a previous fracture as an adult?

Ms. MOENSTER: None.

Dr. WATTS: Is there a family history of osteoporosis?

Ms. MOENSTER: Definitely. Yes.

Dr. WATTS: OK. Well, this is more specific than that. So we've talked and I know your mother got shorter and had spinal deformity that's called a dowager's hump, but this specifically asks did one of your parents have a hip fracture.

Ms. MOENSTER: No hip fracture.

MIKKELSON: The questions continue. Are you a current smoker? Have you used prescription steroid medications? Do you have rheumatoid arthritis or untreated thyroid disease? All of these influence the risk of fractures.

After all the questions are answered, Watts clicks the calculate button at the bottom of the screen.

Dr. WATTS: When we push that button, it gives us the 10 year probability of fracture.

MIKKELSON: And the two numbers that appear are surprisingly good news. Moenster's risk of hip fracture over the next decade is less than 1 percent. For other major breaks her risk is 12 percent.

Dr. WATTS: We're getting a thumbs up.

Ms. MOENSTER: I'm really happy with that. That is really good news, because when I came here I was scared to death.

MIKKELSON: The National Osteoporosis Foundation guidelines call for treating patients with drugs if their 10 year risk of hip fracture is 3 percent or higher, or if their risk of other major fractures is 20 percent. Watts says Moenster's numbers clearly fall under these thresholds.

Dr. WATTS: And so we concluded not only was it safe for her to stay off the medication that she'd stopped, but she didn't necessarily have to stay on the other mediation either.

MIKKELSON: Moenster decided to stay on the one drug called Evista. She sees it as a sort of insurance policy. And with a more accurate picture of her long-term risks, Moenster sys she no longer pictures her bones turning to cottage cheese.

Allison Aubrey, NPR News.

MONTAGNE: You can find a link to the WHO online calculator, plus tips for preventing osteoporosis, at our Web site, npr.org/yourhealth.

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