Personal history of fracture as an adult

History of fracture in first-degree relative

Female gender

Advanced age

White race

Dementia

Current cigarette smoking

Estrogen deficiency

 Early menopause (<45 years) or bilateral ovariectomy

 Prolonged premenstrual amenorrhea (>1 year)

Poor nutrition especially low calcium and vitamin D intake

Alcoholism

Impaired eyesight despite adequate correction

Recurrent falls

Inadequate physical activity

Poor health/frailty