Older women underestimate risk of bone fracture

Most women who are likely to have a bone fracture do not think they are at greater risk, said a leading Italian rheumatologist at a European conference. This could help to explain why many women do not adhere to preventive treatment.

Professor Silvano Adami from the University of Verona presented results from the GLOW trial, a multinational study involving 60393 women over 55 years in 10 countries in North America, Australia and Europe.  The aim of the study was to compare their perceived risk of fracture with their knowledge of factors that might apply to them that would make them more vulnerable.  “The questionnaires gave us information about their medical history, fracture risks and occurrence, how the women sought to prevent fractures and the diagnosis and treatment of osteoporosis,” he said at the European Symposium on Calcified Tissues in Vienna.

The women who took part rated their perceived risk of fracture using a five-point scale that ranged from ‘much lower’ to ‘much higher’ than other women of the same age, taking into account their weight, smoking status and the use of their arms to stand up.

Of the 25,334 women in Europe who participated, Professor Adami and his colleagues found that 64% with a history of fracture considered their risk of future fracture to be lower than women of the same age.  Among the women diagnosed with osteoporosis, over half of them believed that they were not at increased risk for fracture, and 75% of nearly 18,000 women with a high FRACTURE Index (a tool to predict fracture risk in postmenopausal women) considered themselves not to be at greater risk for fracture than other women their age.  The women who most strongly believed their risk to be high were those diagnosed with osteoporosis or osteopenia, especially if they were being treated with corticosteroid or if they had had a fracture.  Regardless of age and country, these results were consistent.

“Although the risks, treatment and means of helping to prevent a fracture are well known, our data suggest that many women do not persist with medical treatment to lower their risk of fracture,” said Professor Adami.  “We need to understand why some women do not comply with treatment,” he added.