What does FRAX combine to estimate 10-year fracture risk?

• A. Only BMD
• B. Only clinical risk factors
• C. Genetic testing results
• D. Clinical risk factors with BMD

Answer: (D)

FRAX estimates 10-year fracture risk by combining clinical risk factors with bone mineral density (BMD). It uses information such as age, sex, weight, height, prior fracture, parental hip fracture, smoking, alcohol use, glucocorticoid use, rheumatoid arthritis, and secondary osteoporosis, with optional BMD measurement at the femoral neck to refine the risk estimate. The reason this approach is most accurate is that fracture risk is influenced by both bone strength (captured by BMD) and various clinical factors that affect bone quality and fall risk. Genetic testing is not part of FRAX. When BMD is not available, FRAX can still use clinical risk factors alone, but the prediction is less precise.