About 330,000 hip fractures occur each year in the USA. They can result in discomfort, promote disability, and result in loss of independence, so it's good to know what the most common risk factors are. Data from the Women's Health Initiative (WHI) study were used to elaborate a list, which has been published in the Journal of the American Medical Association.

Data from 93,500 women were used to develop an algorithm based on 11 factors to predict the 5-year hip fracture risk. The factors included age, self-reported health, height, weight, fracture after age 54, race/ethnicity, physical activity, smoking, parental fracture, antidiabetic drug use, and corticosteroid use. (For example, a 70-year-old white woman who weighs 120 pounds, is inactive, uses corticosteroids, and rates her health as "fair/poor" would have a 5-year hip fracture risk of 5%.)

The algorithm was compared with bone scans in some 11,000 women. The risk scores appeared to predict hip fracture risk about as well as bone scans. An interesting finding during the creation of the algorithm was that the following factors were not predicative of hip fracture in the next 5 years: educational level, coffee consumption, age at menopause, age at first birth, intentional weight loss, and use of vitamin D supplements, multivitamins, anti-estrogens, and oral contraceptives.

As one of the investigators puts it: "knowing the 5-year risk of fracture will permit patients and physicians to make informed choices when balancing lifestyle changes against undergoing medical interventions. Publication of [this algorithm] will permit others to rapidly test [its] utility." But I wonder how many physicians will actually apply the 11-point algorithm, rather than ordering up a bone density scan?