New findings show that women who are 55 years of age or older who have an increased risk of bone fracture because of their family history or steroid use, for example, tend not to perceive their heightened risk.

The findings, reported here at the European Symposium on Calcified Tissues (ESCT), come from the Global Longitudinal Study of Osteoporosis in Women (GLOW). The study enrolled 60,393 women recruited from 615 primary care physician practices in 10 countries.

While there are many means available to lower fracture risk, patient adherence is often poor, said principal investigator Dr. Silvano Adami, professor of medical and surgical sciences at the University of Verona in Italy. It's important for doctors to identify factors that may enhance or impede patient adherence.

Adami and colleagues compared the self-perceived risk for osteoporotic fracture among women 55 years of age or older with characteristics known to increase fracture risk.

For their analysis, the researchers reviewed the results of questionnaires completed by the participants. In the questionnaires, women were asked to rate their perceived risk of fracture compared with women of the same age using a 5-point scale that ranged from "much lower" to "much higher." The risk factors included a prior bone fracture, a mother who had a hip fracture, weight of less than 125 pounds (57 kg), alcohol intake of more than 20 units per week, current steroid use, and rheumatoid arthritis.

The results for 25,334 European women showed that 66 percent who had a history of fracture perceived their risk of future fracture to be lower than or the same as other women their age. Of the women with a diagnosis of osteoporosis, 55 percent believed that they did not have an increased fracture risk.

The data also showed that 75 percent of women with a high risk of fracture, based on their scores on the FRACTURE Index, felt that their risk was lower or the same as other women their age. The FRACTURE Index is a tool for predicting fracture risk in postmenopausal women that takes into account age, bone mineral density, fracture after 50 years of age, weight of less than 125 pounds, smoking status, and use of arms to stand up from a chair.

The findings were maintained across all age groups and geographic regions (U.S., southern Europe, northern Europe, Canada, and Australia).

When interpreting the findings, Adami cautioned, it's important to take into account that participating physician practices and patients volunteering from those practices may differ from non-participants and thus may not be representative of the general population.

"The main risk factors for osteoporotic fracture have been clearly identified, and it is now the time for women to become fully aware of these risk factors and take appropriate measures," he concluded.