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Osteoporosis is chiefly characterized by increased fracture risk; thus, the primary goal of therapy is to minimize the occurrence of fractures.1 Several agents have been shown to reduce fracture rates in patients who are at moderate-to-high risk. However, demonstrating therapeutic efficacy in low-risk populations is difficult, and treatment of low-risk individuals is not cost-effective.2 Patients should be selected for treatment with osteoporosis medications, based on absolute fracture risk.
Low BMD is an established and strong predictor of fracture risk in older adults, with the relation described by a gradient of increasing risk with decreasing BMD.3 For every one standard deviation decrease in age-adjusted BMD, fractu…