Assessing your risk and testing for bone loss are the keys to diagnosing osteoporosis.

Osteoporosis is a potentially crippling disease characterized by low bone mass (density) and deterioration of bone tissue. The condition leads to increased bone fragility and risk of fracture – most often at the spine, wrist or hip.

Osteoporosis does not develop overnight. You can lose bone mass steadily for many years without experiencing any symptoms or signs of the disease until a bone fractures. For this reason, osteoporosis is often called “the silent thief” – literally stealing our bone mass without giving us any indication whatsoever. If osteoporosis is first diagnosed at the time a fracture occurs, it is already fairly advanced.

Early detection of bone loss, therefore, is critical in preventing osteoporotic fractures. This fact sheet is designed to help you assess your risk of osteoporosis so that you may take preventive action.

Assessing your risk factors

No single cause for osteoporosis has been identified. However, certain factors seem to play a role in the development of osteoporosis. We call these factors “risk factors” because each factor influences our risk of developing the disease. Several of these factors have been shown to be stronger predictors of bone loss than others and are therefore considered major risk factors. Other conditions that may also lead to bone loss are considered minor risk factors. The Osteoporosis Society of Canada (OSC) recommends that all postmenopausal women and men over 50 be assessed for the presence of risk factors for osteoporosis.

Risk factors are additive, meaning that the more risk factors you have, the greater your risk of developing osteoporosis. If you are over 50 and have at least one of the major risk factors or two or more of the minor risk factors, the OSC recommends being tested for osteoporosis.

Furthermore, assessing your risk factors can help you identify those that you can change. Some of these factors are a result of heredity; others are lifestyle factors. By making changes in your lifestyle, you are doing something to improve your bone health and lower your risk of developing osteoporosis.

Assessing your risk and testing for bone loss are the keys to diagnosing osteoporosis.

Risk Factors

How Important are the Risk Factors?
Many people who develop osteoporosis have few of the risk factors – a fact trying to be understood through research into the causes of osteoporosis.

This is why testing is so important. The tests are known as Bone Mineral Density (BMD) tests and the technology is known as bone densitometry. These tests are safe, painless and accurately measure the density of your bones. A BMD test can tell you whether or not you have osteoporosis and how likely you are to develop it in the future, and can help you to make decisions that may prevent fractures or further bone loss.

Major risk factors for fracture

• Low bone mineral density (BMD)
• Prior fragility fracture
• Age – the risk of fracture increases with age
• Family history of osteoporotic fracture
• Tendency to fall

Major risk factors

• Fracture with minimal trauma after age 40
• Family history of osteoporotic fracture (especially if your mother had a hip fracture)
• Long-term (more than 3 months) use of glucocorticoid therapy such as prednisone
• Medical conditions (such as celiac disease, Crohn’s disease) that inhibit absorption of nutrients
• Primary hyperparathyroidism
• Tendency to fall
• Osteopenia apparent on x-ray
• Hypogonadism (low testosterone in men, loss of menstrual periods in younger women)
• Early menopause (before age 45)

Minor risk factors

• Rheumatoid arthritis
• Hyperthyroidism
• Prolonged use of anticonvulsants
• Prolonged heparin use
• Body weight less than 57 kg (125 lbs.)
• Low calcium intake
• If your present weight is more than 10% below your weight at age 2
• Excess caffeine (consistently more than 4 cups a day of coffee,
  tea, cola)
• Excess alcohol (consistently more than 2 drinks a day)
• Smoker

Because the main health implication of osteoporosis is the increased possibility of fracture, the OSC recommends that you also consider your risk factors for fracture.