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In BMD test results, your bones are compared to the bones of an average young adult. A score (called a
T-score) is calculated that describes the density of your bones (usually at the spine and hip) and tells you
how strong your bones are compared to this average. While some bone loss with aging is considered normal,
making such comparisons helps to determine whether you are losing bone more rapidly than expected for someone
your age.
The T-score is expressed in units referred to as standard deviations (SDs). These SD units tell us how
far you differ (or deviate) from what is considered normal for a young adult. Below normal is always
indicated with a minus (-) sign. According to World Health Organization (WHO) classifications, a T-score
below 2.5 SDs indicates osteoporosis and a score between 1 and 2.5 SDs indicates osteopenia or low bone
density. Normal bone density is no more than 1 SD below the young adult normal value. Your BMD test results
and the WHO classifications are only part of the picture in determining your risk for fracture.
Your BMD test results and the WHO classifications are only part of the picture in determining your risk
for fracture.
Determining Your 10-Year Absolute Fracture Risk
In addition to your BMD results, your physician will consider factors such as your age, gender, fracture
history, family history and glucocorticoid (steroid) use to determine your 10-year absolute fracture
risk.
Tables 1 and 2 are used to determine whether your 10-year fracture risk is low, moderate or high,
considering your BMD results, age and gender. Other clinical factors, particularly a fragility fracture after
age 40 or glucocorticoid use for more than three months, substantially elevate your fracture risk. The
presence of either of these factors will increase your 10-year risk of fracture to the next level. If both of
these particular factors were present, you would be considered at high risk regardless of your BMD
result.
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Table 1 - 10 year fracture risk for women
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Table 2 - 10 year fracture risk for men
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Your 10-year fracture risk will change with advancing age or with the development of new risk factors.
Repeat assessment is appropriate in five to 10 years in those with low risk and in one to five years in those
with moderate risk.
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