Tufts University researcher Bess Dawson-Hughes, M.D., chaired the committee that recently updated the National Osteoporosis Foundation (NOF) Clinician's Guide to Prevention and Treatment of Osteoporosis. The new Clinician's Guide incorporates the World Health Organization (WHO) absolute fracture prediction algorithm (FRAX®), a computer-based tool expected to increase the identification of patients at risk for osteoporosis.
"The ability to estimate 10-year fracture risk is a crucial development in osteoporosis care, but it is still important for clinicians to review patient cases on an individual basis," says Dawson-Hughes. "Ten-year fracture risk should be used as a guideline."
The following are some recommendations from the new Clinician's Guide:
* BMD testing for women age 65 and older and men age 70 and older and in post-menopausal women age 50-70 who present with certain risk factors.
* Treatment in postmenopausal women and in men age 50 and older with low bone mass at the femoral neck, total hip or spine and 10-year hip fracture probability of 3 percent or more, or, a 10-year major fracture risk of 20 percent or more based on the US-adapted WHO absolute fracture risk model.
* Regular weight-bearing and muscle-strengthening exercise to reduce the risk of falls and fractures.
* Advise on adequate amounts of calcium (at least 1200 mg per day, including supplements (if necessary) and vitamin D (800 to 1000 IU per day of vitamin D for individuals at risk of insufficiency).
"We continue to stress the importance of taking calcium and vitamin D for optimal bone health," says Dawson-Hughes, who has published several papers on the subject. "Previous studies suggest these nutrients help strengthen bones which is beneficial for all adults, even those who show no signs of osteoporosis."
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