Risk assessment: Theoretical considerations

Measurements of bone mass and several other skeletal characteristics can effectively identify women at high risk for fractures. These measurements are now widely available, and other clinical data cannot provide equivalent information. Treatments exist that will preserve bone mass and presumably reduce fracture risk (although for newer treatments this requires further study). It should also be noted that the prevention of very rapid bone loss may also protect against the development of micro-architectural abnormalities, thereby further reducing risk. Even in the very old, for whom preservation of bone mass may be of less value, there now appears to be an intervention that diminishes the impact trauma associated with falls. In this group bone mass measurements may also aid in identification of the highest risk groups. It is worth noting that measurement of bone mass may further serve to motivate patients to accept or to continue with a therapy.