Bone mass accumulates during growth and peaks at approximately 30 years of age, thereafter remaining relatively stable. In postmenopausal women, however, an accelerated annual bone mineral density (BMD) loss of 2-4% is observed, and a cumulative 25-30% reduction in BMD over 10 years significantly increases the risk for major osteoporotic fracture (MOF) (Figure 1). Furthermore, data suggest that BMD loss may be even greater in postmenopausal women who are HIV-infected than those who are not.

This second module presented by the National Osteoporosis Foundation of South Africa (NOFSA) has a specific focus on the use of FRAX for the assessment of fracture risk in South African clinical practice.

You will gain an understanding of:

• Factors that contribute to increased postmenopausal risk for major osteoporotic fracture
• The appropriate use of dual-energy x-ray absorptiometry (DXA) and clinical interpretation of the DXA-derived T-score
• The appropriate use of FRAX fracture risk assessment in South African everyday clinical practice and how to adjust FRAX in the presence of risk factors that are not accommodated by the FRAX tool
• An approach to stratifying fracture risk and an understanding of intervention thresholds
• An approach to investigating osteoporosis/fragility fractures.

Professor Celia Gregson
NIHR Global Health Professor of Healthy Ageing, Professor of Clinical Epidemiology and Consultant Orthogeriatrician, University of Bristol, UK. The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Zimbabwe.

Celia Gregson is a Professor of Clinical Epidemiology and a NIHR Global Health Research Professor of Healthy Ageing in sub-Saharan Africa, leading the Global Health and Ageing Research Unit at the University of Bristol and the Health Research Unit of Zimbabwe within the Biomedical Research and Training Institute in Harare. She is an Honorary Consultant Orthogeriatrician at the Royal United Hospital NHS Foundation Trust in Bath, UK.