Osteoporosis International

, Volume 21, Issue 1, pp 41–52

The potential impact of new National Osteoporosis Foundation guidance on treatment patterns

  • B. Dawson-Hughes
  • A. C. Looker
  • A. N. A. Tosteson
  • H. Johansson
  • J. A. Kanis
  • L. J. MeltonIII
Original Article



This analysis of National Health and Nutrition Examination Survey III data describes the prevalence of risk factors for osteoporosis and the proportions of men and postmenopausal women age 50 years and older who are candidates for treatment to lower fracture risk, according to the new FRAX®-based National Osteoporosis Foundation Clinician's Guide.


Little information is available on prevalence of osteoporosis risk factors or proportions of US men and women who are potential candidates for treatment.


The prevalence of risk factors used in the new National Osteoporosis Foundation (NOF) FRAX®-based Guide to the Prevention and Treatment of Osteoporosis was estimated using data from the third National Health and Nutrition Examination Survey (NHANES III). Risk factors not measured in NHANES III were simulated using World Health Organization cohorts. The proportion of US men and postmenopausal women age 50+ years who are treatment candidates by the new NOF Guide were calculated; for non-Hispanic white (NHW) women, the proportion eligible by the new NOF Guide was compared with that based on an earlier NOF Guide.


Twenty percent of men and 37% of women were potential candidates for treatment to prevent fractures by the new NOF Guide. Among NHW women, 53% were potential candidates by the previous NOF Guide compared with 41% by the new guide.


One fifth of men and 37% of postmenopausal women are eligible for osteoporosis treatment consideration by the new NOF Guide. However, fewer NHW women are eligible by the new guide than by the previous NOF Guide.


National Osteoporosis Foundation Clinician's Guide Osteoporosis Osteoporosis risk factors Prevalence Treatment eligibility ± population-based study 


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2009

Authors and Affiliations

  • B. Dawson-Hughes
    • 1
  • A. C. Looker
    • 2
  • A. N. A. Tosteson
    • 3
  • H. Johansson
    • 4
  • J. A. Kanis
    • 4
  • L. J. MeltonIII
    • 5
  1. 1.Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts UniversityBostonUSA
  2. 2.National Center for Health StatisticsCenters for Disease Control and PreventionHyattsvilleUSA
  3. 3.Multidisciplinary Clinical Research Center in Musculoskeletal Diseases and The Dartmouth Institute for Health Policy and Clinical PracticeDartmouth Medical SchoolLebanonUSA
  4. 4.WHO Collaborating Centre for Metabolic Bone DiseasesUniversity of Sheffield Medical SchoolSheffieldUK
  5. 5.Division of Epidemiology, College of MedicineMayo ClinicRochesterUSA

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