Bazelier MT, van Staa TP, Uitdehaag BM, Cooper C, Leufkens HG, Vestergaard P, Bentzen J, de Vries F. A simple score for estimating the long-term risk of fracture in patients with multiple sclerosis. Neurology. 2012 Aug 15. [Epub ahead of print]
OBJECTIVE: To derive a simple score for estimating the long-term risk of osteoporotic and hip fracture in individual patients with MS.
METHODS: Using the UK General Practice Research Database linked to the National Hospital Registry (1997-2008), we identified patients with incident MS (n = 5,494). They were matched 1:6 by year of birth, sex, and practice with patients without MS (control subjects). Cox proportional hazards models were used to calculate the long-term risk of osteoporotic and hip fracture. We fitted the regression model with general and specific risk factors, and the final Cox model was converted into integer risk scores.
RESULTS: In comparison with the FRAX calculator, our risk score contains several new risk factors that have been linked with fracture, which include MS, use of antidepressants, use of anticonvulsants, history of falling, and history of fatigue. We estimated the 5- and 10-year risks of osteoporotic and hip fracture in relation to the risk score. The C-statistic was moderate (0.67) for the prediction of osteoporotic fracture and excellent (0.89) for the prediction of hip fracture.
CONCLUSION: This is the first clinical risk score for fracture risk estimation involving MS as a risk factor.
We know that MSers are at a higher risk for hip fracture. This data helps with any individual MSer risk calculation. It includes recently accepted factors such as use of antidepressants, use of anticonvulsants, history of falling, and history of fatigue.
And if you want to keep your risk at the lowest you can help your bone health with a good weight (not too thin and not too heavy), keeping active and doing weight bearing exercises if possible, taking anti-osteoporosis medication if on long-term steroids, and keeping your vitD levels at a high levels (role in absorption of calcium in the gut and bone metabolism).