Association between the IOF One-Minute Osteoporosis Risk Test and FRAX® estimates in middle-aged and older adults: a cross-sectional study

Abstract

Background. Osteoporosis is often asymptomatic until a fragility fracture occurs. The IOF One-Minute Osteoporosis Risk Test and the Fracture Risk Assessment Tool (FRAX®) are widely used clinical tools for identifying individuals at increased fracture risk. This study aimed to evaluate the association between IOF One-Minute Osteoporosis Risk Test scores and FRAX®-estimated 10-year probabilities of major osteoporotic and hip fractures among middle-aged and older Indonesian adults. Methods. This cross-sectional study analyzed secondary data from two community-based osteoporosis screening events in Indonesia. A total of 356 middle-aged and older adults with complete IOF One-Minute Osteoporosis Risk Test and FRAX® assessments were included. Ten-year probabilities of major osteoporotic and hip fractures were calculated using the Indonesian FRAX® model without bone mineral density (BMD). Associations between the IOF One-Minute Osteoporosis Risk Test score and FRAX®-estimated fracture probabilities were analyzed using Spearman correlation analysis, with statistical significance set at p < 0.05. Results. Among 356 participants (93.5% women), most were classified as low risk by both the IOF One-Minute Osteoporosis Risk Test and FRAX®. IOF One-Minute Osteoporosis Risk Test scores showed weak but statistically significant positive correlations with FRAX®-estimated major osteoporotic fracture probability (rs = 0.228, p < 0.001) and hip fracture probability (rs = 0.191, p < 0.001). These findings indicate that higher questionnaire scores were associated with higher estimated fracture probabilities, although the strength of the associations was modest. Conclusion. The IOF One-Minute Osteoporosis Risk Test score was weakly but significantly associated with FRAX®-estimated 10-year probabilities of major osteoporotic and hip fractures among middle-aged and older Indonesian adults. These findings support the complementary use of both tools for preliminary fracture risk assessment in community settings but do not establish diagnostic accuracy or interchangeability with DXA.