FRAX tool underestimates the risk of osteoporotic fractures in mental disorders

COMMENTARY ON: Bolton JM, Morin SN, Majumdar SR, et al. Association of mental disorders and related medication use with risk for major osteoporotic fractures. JAMA Psychiatry 2017;74:641–8.

What is already known on this topic

Selected mental disorders and specific psychotropic medications are associated with increased risk of fracture and osteoporosis and adversely impact bone mineral density (BMD).1 2 Fractures are associated with high mortality and morbidity rates and increased disability burden and socioeconomic costs.3 FRAX, a fracture risk assessment tool, assesses the 10-year probability of major osteoporotic fractures (MOF) based on eight clinical risk factors and BMD.4 5 It was developed and calibrated based on population-based cohorts in several regions throughout the world. Although FRAX is included in numerous osteoporosis guidelines, there is a need to strengthen the tool by incorporating additional clinical risk factors and evaluating its utility in specific…

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