Early detection of osteoporosis in adult children of patients with proximal femur fractures: a real-world screening study

Background Osteoporosis is often undiagnosed until fractures occur. A parental history of proximal femur fracture is an independent risk factor for osteoporosis in the next generation. This study evaluated whether adult children of affected patients represent a suitable target group for early screening. Methods Over 12 months, patients aged ≥ 70 years with low-energy proximal femur fractures were enrolled. Their adult children were invited to participate. Medical history, laboratory testing, and fracture risk assessment using FRAX ® were performed. Treatment thresholds followed AACE guidelines (≥ 3% proximal femur fracture or ≥ 20% major osteoporotic fracture [MOF] risk). Results Of 189 patients screened, 183 were eligible (mean age 83 years). Sixty adult children participated (mean age 62 years). One had a prior osteoporosis diagnosis; nine reported previous MOF. Based on FRAX ® , 40% exceeded treatment thresholds. Vitamin D insufficiency was present in 85%, with supplementation associated with higher serum concentrations. Conclusions Adult children of patients with proximal femur fractures represent a high-risk group for osteoporosis. Nearly half met treatment thresholds, supporting targeted screening in individuals ≥ 50 years when a parent sustains such a fracture. This approach may enable earlier diagnosis and prevention of osteoporotic fractures.