Use this test to evaluate your
osteoporosis risk level. The risk factors listed below have been identified as
contributors to the onset of osteoporosis.
|
| General Information |
YES |
NO |
| Are you female? |
|
|
| Are you Caucasian
or Asian? |
|
|
| Do you have a fair
complexion? |
|
|
| Do you have a
small-boned frame? |
|
|
| Are you over 40
years old? |
|
|
| Do you have a lean
build or low percentage of body fat (less than 15% of total body weight)? |
|
|
| The
following 5 questions are for women only. |
YES |
NO |
| Have you breast
fed at least one child? |
|
|
| Have you not had
children? |
|
|
| Are you
postmenopausal? |
|
|
| Did your menopause
occur before age 46? |
|
|
| Do you exercise a
great deal, with irregular or no menstruation? |
|
|
| Nutrition
and Exercise |
YES |
NO |
| Do you smoke
cigarettes (at least half a pack per day)? |
|
|
| Do you drink
alcoholic beverages (at least two per day)? |
|
|
| Do you avoid milk
and other dairy products? |
|
|
| Is your diet high
in animal protein, such as red meat? |
|
|
| Are you a
vegetarian or have a diet heavily weighted toward vegetables? |
|
|
| Do you have an
eating disorder or consume too little nutritious food? |
|
|
| Do you consume
more than 3 cups of coffee per day or an equivalent amount of caffeine from other sources
such as cola-type beverages? |
|
|
| Do you exercise
infrequently or not at all? |
|
|
| Family
History |
YES |
NO |
| Do you have a
family history of osteoporosis or other bone disease? |
|
|
| Do you have
relatives who have suffered a broken hip, shoulder or wrist after age 45? |
|
|
| Do you have
relatives who have lost height as they grew older? |
|
|
| Patient
History - Medications |
YES |
NO |
| Have you taken any
of the following medications or treatment? |
|
|
| Steroid
(prednisone, cortisone, etc.) |
|
|
| Thyroid
medication |
|
|
|
Anticonvulsants (for seizures, epilepsy) |
|
|
| Loop
diuretics (Lasix, Burnex, Edicrin) |
|
|
| Heparin |
|
|
|
Chemotherapy |
|
|
| GnRH
Agonists |
|
|
| Medical
History |
YES |
NO |
| Have you had any
of the following conditions or surgeries? |
|
|
|
Hyperthyroidism or hyperparathyroidsm |
|
|
| Liver
problems |
|
|
| Kidney
disease |
|
|
| Rheumatoid
(or other) arthritis |
|
|
| Epilepsy |
|
|
|
Insulin-dependent diabetes mellitus |
|
|
| Part of
stomach removed |
|
|
| Fractured
bone(s) |
|
|
| Ovaries
removed before menopause |
|
|
| Chronic
gastrointestinal disorders |
|
|
| Paget's
disease |
|
|
| Prolonged
immobilization |
|
|
There are 41 questions on this test. How many times
did you answer YES?
The more times you answer YES, the greater your risk for
potential osteoporosis. If your risk level appears high, ask your doctor about bone
densitometry and osteoporosis therapy.
|
