How does the Osteoporosis Risk Calculator work?

Enter your sex, age, height, weight (metric or imperial), fracture history, rheumatoid arthritis status, and sex-specific factors (SCORE inputs for women: ethnicity, menopause, estrogen use; MORES inputs for men: COPD). Select any additional clinical risk factors (parental hip fracture, smoking, glucocorticoids, alcohol, secondary causes). We calculate your OST score = (weight kg − age) × 0.2, plus SCORE (women) or MORES (men), classify overall risk, and provide DXA bone density testing guidance with nutrition, exercise, and prevention recommendations.

What is the OST score and how is it calculated?

OST (Osteoporosis Self-Assessment Tool) = (body weight in kg − age in years) × 0.2, truncated to an integer. Developed by Koh et al. (2001) and validated across Asian, European, and North American populations. Risk categories: Low (OST > −1), Moderate (−4 to −1), High (< −4). OST ≤ −3 commonly triggers BMD testing recommendation with ~70–74% sensitivity for osteoporosis.

What is the difference between OST, SCORE, and MORES?

OST uses only age and weight — simplest tool, works for both sexes. SCORE (Simple Calculated Osteoporosis Risk Estimation) adds ethnicity, fracture history, rheumatoid arthritis, and estrogen use for postmenopausal women; cutoff ≥ 6 recommends DXA. MORES (Male Osteoporosis Risk Estimation Score) uses age bands, weight bands, and COPD for men; cutoff ≥ 6 recommends DXA. Our calculator shows OST for everyone plus the sex-appropriate secondary score.

When should I get a DXA bone density scan?

DXA is recommended if: OST ≤ −3, SCORE ≥ 6 (women), MORES ≥ 6 (men), prior fragility fracture, age 65+ (women) or 70+ (men) with risk factors, BMI < 19, long-term glucocorticoid use, or multiple FRAX-equivalent risk factors. USPSTF recommends screening women 65+; discuss earlier screening if you have risk factors. DXA measures lumbar spine and hip T-scores — T ≤ −2.5 defines osteoporosis.

What T-score means osteoporosis vs osteopenia?

T-score compares your BMD to a healthy 30-year-old: Normal (T > −1.0), Osteopenia (T −1.0 to −2.5), Osteoporosis (T ≤ −2.5). Osteopenia still warrants lifestyle intervention and may need medication if fracture risk is high (FRAX). Z-score compares to age-matched peers — used for premenopausal women and men under 50.

Why is low body weight a risk factor for osteoporosis?

Lower weight means less mechanical loading on bones (reduced osteogenic stimulus), often lower muscle mass, and sometimes inadequate nutrition. OST directly incorporates weight — lighter individuals score higher risk. BMI < 19 is an independent FRAX risk factor. Conversely, higher BMI is modestly protective for BMD but does not eliminate osteoporosis risk.

How does menopause affect osteoporosis risk?

Estrogen protects bone by slowing osteoclast activity. At menopause, women lose 2–3% bone density per year for 5–7 years — up to 20% total. Early menopause (before 45) increases lifetime fracture risk. SCORE incorporates estrogen use history. Postmenopausal women should discuss DXA at age 65 or earlier with risk factors.

Can men get osteoporosis?

Yes — about 20% of osteoporosis patients are men. Men develop it ~10 years later than women but have higher mortality after hip fracture. Risk factors include low testosterone, glucocorticoids, COPD, alcohol, smoking, and hypogonadism. MORES was developed specifically for male screening. Men 70+ or with risk factors should consider DXA.

How much calcium and vitamin D do I need for bone health?

Adults: 1,000–1,200 mg calcium and 800–1,000 IU vitamin D daily (ICMR/WHO/NOF). Indian diets often provide 400–600 mg calcium — supplement if dietary intake is low. Vitamin D deficiency is common in India; test 25-OH-D if high risk. Use our Vitamin D Deficiency Calculator for personalized estimates. Adequate protein (1.0–1.2 g/kg/day) also supports bone and muscle.

What exercises help prevent osteoporosis?

Weight-bearing activities (walking, jogging, stair climbing, dancing) and progressive resistance training (weights, resistance bands) stimulate bone formation. Balance training (tai chi, single-leg stands) reduces falls. Aim for 3–5 sessions weekly. Avoid high-impact exercise if you have advanced vertebral fractures — consult your doctor first.

Do smoking and alcohol affect bone density?

Yes. Smoking accelerates bone loss, impairs calcium absorption, and delays fracture healing. Alcohol ≥ 3 units daily suppresses osteoblasts and increases fall risk. Quitting smoking improves bone health within years. Limit alcohol to ≤ 2 units daily. Our Pack-Year Smoking Calculator can motivate cessation.

What medications cause bone loss?

Glucocorticoids (prednisone ≥ 3 months) are the most common cause of secondary osteoporosis. Others include aromatase inhibitors, androgen deprivation therapy, anticonvulsants (phenytoin), heparin, proton pump inhibitors (long-term), and some immunosuppressants. If on these medications, discuss DXA and bone-protective therapy with your doctor.

What is a fragility fracture?

A fracture from a fall at standing height or less — or spontaneous vertebral compression. Common sites: wrist, hip, spine. A fragility fracture after age 50 often indicates clinical osteoporosis and warrants DXA plus treatment evaluation, even if T-score is above −2.5 in some guidelines.

How accurate is this osteoporosis risk calculator?

OST, SCORE, and MORES are validated in peer-reviewed studies with known sensitivity and specificity for low BMD — but no screening tool is perfect. This calculator does not replace DXA, FRAX with BMD, or clinical judgment. Individual genetics, exact bone turnover markers, and hidden conditions can differ from screening estimates. Use results to guide conversations with your healthcare provider.

What is FRAX and does this calculator replace it?

FRAX (Fracture Risk Assessment Tool) estimates 10-year probability of hip and major osteoporotic fracture using clinical risk factors with optional BMD. Our calculator uses related screening tools (OST/SCORE/MORES) and clinical factors but does not compute FRAX probability. If DXA shows osteopenia, your doctor may run FRAX to decide on pharmacotherapy.

What are the warning signs of osteoporosis?

Osteoporosis is often silent until a fracture occurs. Warning signs include: height loss over time, developing a stooped posture (dowager's hump), sudden back pain (vertebral compression), wrist fracture from a minor fall, and recurrent fractures. If you notice these, request DXA and evaluation even if you feel otherwise healthy.

How often should I repeat a bone density scan?

If initial DXA is normal and risk factors are stable, repeat every 2–5 years depending on age and clinical context. After starting osteoporosis medication, DXA may be repeated at 1–2 years to monitor response. Recalculate your OST/SCORE/MORES if you lose significant weight, enter menopause, or start glucocorticoids.

Does osteoporosis run in families?

Yes — genetics influence peak bone mass and fracture risk. A parental hip fracture roughly doubles your risk (a FRAX major factor). Family history does not guarantee osteoporosis, but it strengthens the case for earlier DXA screening, especially combined with low weight, smoking, or early menopause.

Can I reverse osteoporosis with diet and exercise alone?

Lifestyle measures — adequate calcium, vitamin D, weight-bearing exercise, smoking cessation, and fall prevention — are essential and can slow bone loss. Established osteoporosis (T-score ≤ −2.5) or prior fragility fracture often requires medication in addition to lifestyle. Work with your doctor to set realistic goals based on DXA and fracture history.

Is osteoporosis screening covered by insurance in India?

Coverage varies by insurer and plan. Many private health policies cover DXA for high-risk patients with a doctor's referral. Government schemes and corporate health packages may include bone density scans for seniors. Check with your insurer; out-of-pocket cost is typically ₹1,500–4,000 at most diagnostic centres.

Osteoporosis Risk Calculator

Q: What is the difference between OST, SCORE, and MORES?

OST uses only age and weight — simplest tool, works for both sexes. SCORE (Simple Calculated Osteoporosis Risk Estimation) adds ethnicity, fracture history, rheumatoid arthritis, and estrogen use for postmenopausal women; cutoff ≥ 6 recommends DXA. MORES (Male Osteoporosis Risk Estimation Score) uses age bands, weight bands, and COPD for men; cutoff ≥ 6 recommends DXA. Our calculator shows OST for everyone plus the sex-appropriate secondary score.

Q: When should I get a DXA bone density scan?

DXA is recommended if: OST ≤ −3, SCORE ≥ 6 (women), MORES ≥ 6 (men), prior fragility fracture, age 65+ (women) or 70+ (men) with risk factors, BMI < 19, long-term glucocorticoid use, or multiple FRAX-equivalent risk factors. USPSTF recommends screening women 65+; discuss earlier screening if you have risk factors. DXA measures lumbar spine and hip T-scores — T ≤ −2.5 defines osteoporosis.

Q: What T-score means osteoporosis vs osteopenia?

T-score compares your BMD to a healthy 30-year-old: Normal (T > −1.0), Osteopenia (T −1.0 to −2.5), Osteoporosis (T ≤ −2.5). Osteopenia still warrants lifestyle intervention and may need medication if fracture risk is high (FRAX). Z-score compares to age-matched peers — used for premenopausal women and men under 50.

Q: How does menopause affect osteoporosis risk?

Estrogen protects bone by slowing osteoclast activity. At menopause, women lose 2–3% bone density per year for 5–7 years — up to 20% total. Early menopause (before 45) increases lifetime fracture risk. SCORE incorporates estrogen use history. Postmenopausal women should discuss DXA at age 65 or earlier with risk factors.

Q: Can men get osteoporosis?

Yes — about 20% of osteoporosis patients are men. Men develop it ~10 years later than women but have higher mortality after hip fracture. Risk factors include low testosterone, glucocorticoids, COPD, alcohol, smoking, and hypogonadism. MORES was developed specifically for male screening. Men 70+ or with risk factors should consider DXA.

Q: How much calcium and vitamin D do I need for bone health?

Adults: 1,000–1,200 mg calcium and 800–1,000 IU vitamin D daily (ICMR/WHO/NOF). Indian diets often provide 400–600 mg calcium — supplement if dietary intake is low. Vitamin D deficiency is common in India; test 25-OH-D if high risk. Use our Vitamin D Deficiency Calculator for personalized estimates. Adequate protein (1.0–1.2 g/kg/day) also supports bone and muscle.

Q: What exercises help prevent osteoporosis?

Weight-bearing activities (walking, jogging, stair climbing, dancing) and progressive resistance training (weights, resistance bands) stimulate bone formation. Balance training (tai chi, single-leg stands) reduces falls. Aim for 3–5 sessions weekly. Avoid high-impact exercise if you have advanced vertebral fractures — consult your doctor first.

Free osteoporosis risk calculator using the validated OST (Osteoporosis Self-Assessment Tool), sex-specific SCORE/MORES screening, clinical risk factors, and DXA bone density testing guidance.

Enter your details — results appear below after you calculate.

Basic information

Units

Sex

Age (years)

OST and SCORE/MORES are validated for adults 40 years and older

Height (cm)

Weight (kg)

Weight is a core OST variable — lower weight increases risk

Fracture & medical history

Prior fracture history

Rheumatoid arthritis

Ethnicity (for SCORE)

Menopause status

Early menopause (before age 45)

Ever used estrogen / HRT

Additional clinical risk factors

Select all that apply — aligned with FRAX major risk factors and IOF osteoporosis screening guidelines.

Parent had hip fractureCurrent cigarette smokerOral steroids ≥ 3 months (prednisone, etc.)Alcohol ≥ 3 units dailySecondary cause (hyperthyroid, celiac, IBD, malabsorption)

How this Osteoporosis Risk Calculator works

Enter your sex, age, height, and weight (metric or imperial). Add fracture history, rheumatoid arthritis, and sex-specific factors — SCORE inputs for women (ethnicity, menopause, estrogen use) or MORES for men (COPD). Select any additional clinical risk factors aligned with FRAX guidelines.

We calculate your OST score = (weight kg − age) × 0.2, plus SCORE or MORES, classify overall risk, and provide DXA bone density testing guidance with calcium, vitamin D, exercise, and prevention recommendations.

Pair with our Vitamin D Deficiency Calculator, Sarcopenia Risk Calculator, and Frailty Index Calculator for comprehensive musculoskeletal screening.

Osteoporosis Risk Calculator – OST, SCORE, MORES & DXA Screening Guidance

Millions search "osteoporosis risk calculator", "bone density test who needs it", "OST score osteoporosis", and "am I at risk for osteoporosis" each year. Osteoporosis — silent bone loss leading to fragility fractures — affects an estimated 200 million people worldwide. Our free Osteoporosis Risk Calculator uses validated screening tools: the OST (Osteoporosis Self-Assessment Tool), SCORE for women, MORES for men, plus FRAX-aligned clinical risk factors to guide DXA bone density testing.

Pair results with our Vitamin D Deficiency Calculator, Sarcopenia Risk Calculator, Frailty Index Calculator, and Menopause Symptom Calculator for comprehensive musculoskeletal and aging wellness.

Why Screen for Osteoporosis?

Osteoporosis is defined by the WHO as bone mineral density (BMD) ≥ 2.5 standard deviations below the young-adult mean (T-score ≤ −2.5). Osteopenia (T-score −1.0 to −2.5) also increases fracture risk. Hip and vertebral fractures cause disability, chronic pain, and significant mortality — especially in older adults. Yet osteoporosis is often undiagnosed until the first fracture occurs.

DXA (dual-energy X-ray absorptiometry) is the gold-standard test, but it is not practical for universal screening. Validated risk tools like OST, SCORE, and MORES help identify who benefits most from DXA, reducing unnecessary testing while catching high-risk individuals early.

1What Is the OST (Osteoporosis Self-Assessment Tool)?

OST was developed by Koh et al. (2001) using data from postmenopausal women across eight Asian countries and later validated in European and North American populations. It requires only age and weight:

OST = (weight in kg − age in years) × 0.2

Lower OST scores indicate higher osteoporosis screening priority. Because weight is in the numerator, lighter individuals and older adults tend toward lower scores — matching clinical fracture risk patterns.

OST Score Interpretation

OST score	Risk category	Typical action
> −1	Low	Lifestyle prevention; routine counseling
−4 to −1	Moderate	Reinforce calcium, vitamin D, exercise; consider DXA if other risk factors
< −4	High	DXA recommended; evaluate modifiable factors
≤ −3	BMD screening cutoff	Commonly used threshold to refer for bone density testing (~70–74% sensitivity)

2SCORE for Women & MORES for Men

SCORE (Simple Calculated Osteoporosis Risk Estimation) by Lydick et al. incorporates age, weight, ethnicity, fracture history, rheumatoid arthritis, and estrogen use. A score ≥ 6 recommends DXA screening in postmenopausal women.

MORES (Male Osteoporosis Risk Estimation Score) by Shepherd et al. uses age bands, weight bands, and COPD to identify men at risk. A score ≥ 6 recommends DXA. Men develop osteoporosis later than women but have higher mortality after hip fracture.

Tool	Population	Key inputs	DXA cutoff
OST	Men & women	Age, weight	≤ −3
SCORE	Postmenopausal women	Age, weight, ethnicity, fracture, RA, estrogen	≥ 6
MORES	Men	Age band, weight band, COPD	≥ 6

3Clinical Risk Factors (FRAX-Aligned)

Our calculator captures major FRAX risk factors: parental hip fracture, current smoking, glucocorticoid use ≥ 3 months, heavy alcohol (≥ 3 units/day), rheumatoid arthritis, and secondary causes (hyperthyroidism, celiac disease, IBD). Prior fragility fracture is the strongest predictor — often warranting treatment evaluation even when BMD is not yet measured.

Low BMI (< 19) — independent fracture risk factor
Early menopause (< 45) — accelerated estrogen loss
Smoking — accelerates bone loss and impairs healing; use our Pack-Year Smoking Calculator
Glucocorticoids — among the strongest medication causes of secondary osteoporosis
COPD in men — incorporated in MORES; screen with our COPD Risk Assessment Calculator

4Example: OST & SCORE Calculation

A 68-year-old postmenopausal woman weighs 52 kg, is of non-Black ethnicity, has no prior fracture, no RA, never used estrogen:

OST = (52 − 68) × 0.2 = −3 — meets BMD screening cutoff
SCORE ethnicity → +2
SCORE fracture → 0
SCORE RA → 0
SCORE estrogen (never) → −2
SCORE age component (3×68/10) → +20
SCORE weight component (−115 lb/10) → −12
SCORE total ≈ 8 — DXA recommended (≥ 6)

This illustrates how low weight and older age push both OST and SCORE toward screening — even without a prior fracture.

DXA T-Score Interpretation (After Bone Density Scan)

Once DXA is performed, results are reported as T-scores at the lumbar spine and hip. This calculator screens for who needs testing — it does not assign T-scores.

T-score	Classification	Typical management
> −1.0	Normal	Prevention: calcium, vitamin D, exercise
−1.0 to −2.5	Osteopenia	Lifestyle + FRAX; medication if high fracture risk
≤ −2.5	Osteoporosis	Pharmacotherapy per guidelines + fall prevention

5DXA Bone Density Testing — What to Expect

DXA measures BMD at the lumbar spine and hip, producing T-scores compared to healthy young adults. The scan takes 10–15 minutes, involves minimal radiation (less than a chest X-ray), and requires no fasting. Available at hospital radiology departments and diagnostic centres across India.

Lie still on a padded table while a low-dose X-ray arm passes over the hip and spine
No injection or contrast required
Results usually available within 24–48 hours
Cost in India: roughly ₹1,500–4,000 depending on city and facility

6Osteoporosis & Bone Health in India

Studies suggest high prevalence of vitamin D deficiency and suboptimal dietary calcium among Indian adults — both critical for bone mineralization. Vegetarian diets, limited fortified foods in rural areas, indoor lifestyles, and covered clothing reduce vitamin D synthesis. Postmenopausal women and elderly men in urban and rural India both benefit from proactive screening when risk factors are present.

Calcium sources: milk, curd, paneer, ragi, sesame (til), almonds, small fish with bones
Vitamin D: safe sun exposure plus supplementation when deficient — see our Vitamin D Calculator
Protein: adequate intake supports muscle-bone unit; pair with Protein Target Calculator

7Prevention — Calcium, Vitamin D & Exercise

Adequate calcium (1,000–1,200 mg/day) and vitamin D (800–1,000 IU/day) are foundational per ICMR, WHO, and NOF guidance. Weight-bearing exercise (walking, jogging, stairs) and resistance training stimulate bone formation. Balance exercises (tai chi) reduce falls.

Osteoporosis Treatment Overview (If Diagnosed)

Bisphosphonates (alendronate, zoledronic acid) — first-line for many patients
Denosumab — RANKL inhibitor for high-risk or bisphosphonate-intolerant patients
Teriparatide / abaloparatide — anabolic agents for severe osteoporosis
Raloxifene — SERM option for postmenopausal women
Calcium + vitamin D supplementation — adjunct to all pharmacotherapy
Fall prevention — home safety, vision correction, medication review

8Who Should Use This Calculator?

Women approaching or after menopause (especially age 50+)
Men age 70+ or with risk factors (COPD, low weight, smoking)
Anyone with prior fragility fracture or height loss
Patients on long-term glucocorticoids or aromatase inhibitors
Adults with rheumatoid arthritis, hyperthyroidism, or malabsorption
Those with family history of parental hip fracture

Living Well — Fall Prevention & Bone Protection

Remove home hazards — loose rugs, poor lighting, cluttered walkways
Install grab bars in bathrooms and use non-slip mats
Strength & balance training — tai chi, heel raises, single-leg stands 3× weekly
Review medications — sedatives, antihypertensives, and some antidepressants increase fall risk
Vision & footwear — update glasses; avoid loose slippers
Stay socially active — isolation increases fall risk and reduces activity levels

When to See a Doctor

OST ≤ −3 or SCORE/MORES ≥ 6 — schedule DXA bone density testing
Prior fragility fracture — evaluate and treat as osteoporosis regardless of screening score
Height loss > 4 cm (1.5 inches) — may indicate vertebral compression fractures
Sudden severe back pain — urgent evaluation for vertebral fracture
Women 65+ or men 70+ — routine screening per USPSTF/NOF if never tested
On glucocorticoids ≥ 3 months — request DXA and bone-protective therapy discussion
Early menopause (< 45) — discuss estrogen and bone health with gynaecologist or endocrinologist

Frequently Asked Questions (FAQs)

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Osteoporosis Risk Calculator

Basic information

Fracture & medical history

Additional clinical risk factors

How this Osteoporosis Risk Calculator works

Osteoporosis Risk Calculator – OST, SCORE, MORES & DXA Screening Guidance

Why Screen for Osteoporosis?

1What Is the OST (Osteoporosis Self-Assessment Tool)?

OST Score Interpretation

2SCORE for Women & MORES for Men

3Clinical Risk Factors (FRAX-Aligned)

4Example: OST & SCORE Calculation

DXA T-Score Interpretation (After Bone Density Scan)

5DXA Bone Density Testing — What to Expect

6Osteoporosis & Bone Health in India

7Prevention — Calcium, Vitamin D & Exercise

Osteoporosis Treatment Overview (If Diagnosed)

8Who Should Use This Calculator?

Living Well — Fall Prevention & Bone Protection

When to See a Doctor

Frequently Asked Questions (FAQs)

Related Calculators

Vitamin D Deficiency Risk Assessment Calculator

Sarcopenia Risk Calculator

Fall Risk Assessment Calculator

Frailty Index Calculator

Menopause Symptom Calculator

Corrected Calcium Calculator

Lean Body Mass (LBM) Calculator

Protein Target Calculator

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