Updated 10 October 2026
At a glance
- The Bone Health and Osteoporosis Foundation describes FRAX as a calculator that turns bone density, age, sex, height, weight and answers to 7 questions into chances of fracture over 10 years.
- A 2026 Swiss registry paper of 28 708 people found that 72% received higher probabilities once FRAXplus adjustments such as falls were added to the standard score.
- A table of what goes into the score, an input log, a word list, four steps and a one-page summary follow below.
- Osteoporosis Journey keeps falls, near-falls, DEXA dates and movement notes in one dated history, and its Doctor Report exports that history as a one-page summary.
A FRAX number on a bone density printout looks like a verdict, yet it is an estimate built from a handful of inputs. Some of those inputs, such as height, weight and the last fall, change between visits and live only in your memory.
This guide sets out what a bone health foundation, the FRAX calculator page and three 2026 papers say about the 10-year fracture risk score, then offers a table, an input log, a word list, four steps and a one-page summary for a visit. What any score means for you is a matter for your clinician.
What a bone foundation, the FRAX site and three 2026 papers say about a 10-year fracture risk score
The Bone Health and Osteoporosis Foundation explains the tool this way: "With input of your bone density, your age, sex, height, weight, and answers to 7 questions, FRAX calculates the chances of you having different types of fractures in the next 10 years." It then gives two reference points: "If your 10-year probability of major osteoporotic fracture (meaning a fracture of the spine, hip, shoulder, or forearm) is 20% or more, or the 10-year probability of hip fracture is 3% or more, then a diagnosis of osteoporosis can be made."
The FRAX calculator page adds a detail about where the bone density input comes from: "The site and reference technology is DXA at the femoral neck." It also says that "T-scores are based on the NHANES reference values for women age 20-29 years." In other words, the score borrows one number from a DXA report and combines it with the clinical facts.
The 2026 Swiss registry paper describes an extension: "FRAXplus complements the fracture risk assessment tool (FRAX) by incorporating additional risk factors to adjust 10-yr probabilities of major osteoporotic and hip fractures." Its results include a line that matters for a log: "At the individual level, ≥1 fall and recent vertebral or hip fractures produced the largest differences." The paper covered 28 708 people, and 72% had higher probabilities with the adjusted version.
A Taiwan validation paper states: "However, FRAX with bone mineral density (BMD) may underestimate fracture risk, particularly in older adults." A hip fracture paper shows that the calculation can run without a scan: "Pre-fracture fracture risk was retrospectively estimated using FRAX® based on clinical risk factors only, excluding the index HF."
All five describe an estimate that a clinician reads with the rest of the picture. A diary cannot produce a probability, and it can show a clinician the facts that feed one. Falls, new fractures and measured height are easy to blur after a few months, and a dated line made on the day is a sturdier record than recall.
Near-falls and any new fracture can be entered in the Daily check-in of Osteoporosis Journey (by Health Journey Labs), so the facts that feed a score keep their dates.
A table of FRAX inputs and what each one can look like in a personal record
Reading the sources side by side shows which inputs come from a clinic and which come from daily life.
FRAX inputs table, by Osteoporosis Journey
| Input named in the sources | Where it usually comes from | What a personal record can hold |
|---|---|---|
| Bone density | A DXA report, femoral neck site | Report date and the printed T-score copied as shown |
| Age, sex, height, weight | A clinic visit | The measured height and weight with the date of each measurement |
| Answers to 7 questions | A conversation with the clinician | Your answers as you gave them, with the date |
| Falls in the past year (FRAXplus) | Your own memory | Each fall or near-fall as a dated line |
| Recent fracture of the spine or hip (FRAXplus) | Your history and imaging reports | The date and the bone named in the report |
| Output: 10-year probabilities | The calculator | The printed percentages for major osteoporotic and hip fracture |
The table shows an uneven split between the clinic and daily life. The clinic supplies the scan and the measurements, and you hold the falls and the dates. The Swiss paper gave falls the largest individual effect among the extra items, which makes a dated fall list worth keeping tidy. The guide to preparing for a short osteoporosis visit covers the wider visit, and this table covers a single number inside it.
Each DEXA date and printed score can sit in My Labs of Osteoporosis Journey, beside the entries about falls from the same months.
An input log to keep beside a bone density report and a printed FRAX estimate
This log keeps the raw facts and the printed estimate on the same line, so a change in one can be read against the other. The rows are made up to show the layout.
Table for a FRAX input log, by Osteoporosis Journey
| Date | Height as measured | Weight | Falls or near-falls | New fracture | Printed estimates |
|---|---|---|---|---|---|
| 12 Feb | Value on the form | Value on the form | One near-fall on the stairs | None | Major and hip values as printed |
| 18 Jun | Value on the form | Value on the form | Two near-falls, one fall outdoors | None | Major and hip values as printed |
| 9 Oct | Value on the form | Value on the form | None since June | Wrist fracture in July, per report | Major and hip values as printed |
Copy each number exactly as the form shows it, including units, and leave a cell empty when no one measured that item. Add a few words about the setting of every fall: indoors, outdoors, on a surface that was wet or uneven. A calculator cannot ask about those details, while a clinician can.
Where the same fall appears in more than one place, keep a single dated line and cross-refer. Keep the setting words short and factual, because a clinician reading twelve rows wants the date, the place and the outcome of each fall at a glance. A blank cell is also a useful entry, since it shows the item was considered and nobody measured it. The guide to tracking backward and forward after a late osteoporosis diagnosis explains how to rebuild older dates when only part of the history survives.
The same rows can become dated entries in the Daily Journal of Osteoporosis Journey, with a few words about where each fall happened.
Plain words for describing falls, fractures and score questions to a clinician
Consistent wording makes two entries from different months comparable. Pick from the lists below or add your own.
Words for falls and scores
For falls and scores, Osteoporosis Journey uses the words below.
- Fall words: tripped, slipped, lost balance, stumbled without landing, landed on hip, landed on wrist.
- Setting words: stairs, bathroom, pavement, kitchen, getting out of a car, in the dark.
- Bone words: spine, hip, wrist, shoulder, rib, as named in the report.
- Number words: copied from the form, rounded by the clinician, not measured.
- Question words: which inputs went in, which are missing, who recalculates.
A line such as "slipped on pavement, landed on wrist, no mark afterward" says what happened and leaves the interpretation to others. Short, repeatable phrases also make it easier to count events across months, since the same wording is used each time. Where the details are fuzzy, "about" or "I think" belongs in the entry, because a clinician can tell an estimate from a certainty. The list records events and gives no opinion about risk. When an injury looks serious, such as a bone out of shape or pain that stops movement, the local emergency number comes before any notes.
Any phrase from these lists can be dropped into the Daily Journal of Osteoporosis Journey and reused the next time a similar day arrives.
Four steps to prepare for a clinician visit about a fracture risk estimate
A visit about a printed estimate can be short, and the inputs matter more than the percentages. Four steps keep the facts together.
Steps before a risk estimate visit, by Osteoporosis Journey
- Copy the printed estimates and the report date.
- List falls, near-falls and any new fracture since the last estimate, with dates.
- Write the latest measured height and weight beside the date of each.
- Write two or three questions about which inputs were used and what happens next.
Plain questions work well: which inputs went into this estimate, whether newer facts would change it, and when it will be looked at again. From Osteoporosis Journey, we recommend assembling these facts the evening before (Osteoporosis Journey checklist), so that nothing has to be searched for in the waiting room. The sources describe the calculator in general terms, and the clinician applies it to your own history. The guide to traveling when fall risk feels real is a useful companion if a trip is coming up before the visit.
During the visit, write the answer beside each question and the date of the next contact. If an outside imaging center holds the scan, note which one, so a copy can be requested later.
Inside My Care Team of Osteoporosis Journey, the questions stay attached to the clinician who will answer them.
A one-page summary for the clinician: inputs, falls, printed estimates and questions
One page lets the clinician see the inputs beside the estimate before the first question is asked, and the full folder stays with you.
One-page summary list, by Osteoporosis Journey
- Dates of DEXA reports and the printed T-scores, copied as shown.
- Dates and printed values of every FRAX estimate.
- Measured height and weight with the dates they were taken.
- Falls, near-falls and any new fracture, each with a date and a setting.
- Questions for this visit.
Offer the page as the visit opens and suggest reading it row by row, or ask for it to be placed in the chart. Write each reply with its date. If the clinician recalculates anything during the visit, copy the new printed values onto the page and mark which inputs changed, so the next visit can start from the updated sheet.
The page copies what you recorded. How the estimate is read and what follows from it belong to your clinician, and no page or app decides that. For severe pain after a fall, the local emergency number comes first.
When the entries already live in Osteoporosis Journey, its Doctor Report lays out this page on request.
How Osteoporosis Journey can help
Dated falls, measured height and printed percentages make a fracture risk estimate readable later. If you want them held in one place, the best osteoporosis apps guide compares the options.
Osteoporosis Journey is a personal osteoporosis tracker from Health Journey Labs on the App Store and Google Play. Inputs and estimates on a single line let a change in one be read against the other. What a risk score means for any person is decided by the clinicians who know the full history, and a tidy log lets them start from facts. Below is what you can use and how each part helps.
- My Meds — Logs medicine names, timing, dose; app-specific items: bone medicines, calcium/vitamin D you actually use as directed, pain options your clinician already cleared; read together with movement weeks, sleep, near-falls, the rest of the tracked history.
- Daily check-in — Logs physical symptoms, emotional state, nutrition, sleep, exercise, meds, external factors; app-specific items: pain, movement confidence, near-falls or falls, fear of fracture; read together with the rest of the logged history.
- Daily Journal — Logs free-text notes, voice entry; app-specific items: what movement was limited, footwear or lighting near a stumble, caregiver help, visit debriefs, leftover fear after a fall, a look-fine mismatch line; read together with scores and other logged history (adds context).
- Flare Tracker — Logs flag a day clearly worse than the usual hard week; app-specific items: a real fall, a cluster of near-falls, pain that jumps above baseline; read together with history across weeks (one-off spike vs repeating pattern).
- My Labs — Logs result dates; app-specific items: DEXA, vitamin D, calcium, other bone-related tests; read together with meds, falls, movement, function.
- Learn — Logs short education topics, prompts; app-specific items: meds adherence, falls awareness, cleared movement, visit prep, why fear of falling still belongs in the log; read together with your own logged weeks.
- AI companions — Logs Clara (general chat), specialist companions; app-specific items: knowledge, fitness, nutrition, relationships; read together with your logged history (companions already see it); used for: visit wording; a calm caregiver script; a listening ear after a scary near-fall night.
- Weekly Goals — Logs one small aim, whether it held; read together with real check-ins.
- My Care Team — Logs clinicians, short visit notes; app-specific items: tends to ask mainly about DEXA rather than near-falls; read together with logged history; used for: visit prep (what to ask and bring); notes during the visit; review afterward.
- Doctor Report — Logs one-page summary exported from logged history; app-specific items: dates, meds taken, falls or near-falls, movement, pain, how you functioned; read together with the history already logged; visit type: bone.
- My Assessments — Logs structured check-ins beyond daily scores, onboarding life and social context; read together with ongoing history.
- Food Tracker — Logs meal or drink lines, nutrition; read together with energy, sleep, bone-care.
- Weight Tracker — Logs scale or body notes; read together with the rest of the logged history.
- Period Tracker — Logs start and stop dates, flow, how heavy or light bleeding felt; read together with bone-care or pain, everything else logged.
Everything you log builds one history, and insights get stronger as it grows. Custom symptoms let you add your own labels.
We make Osteoporosis Journey at Health Journey Labs. This guide is educational and does not replace medical advice. Diagnosis, medication decisions, and urgent care decisions belong with your treating clinicians.
Sources
- Bone Health and Osteoporosis Foundation: bone density testing, T-scores and FRAX
- FRAX calculator page, Osteoporosis Research Ltd (University of Sheffield site)
- JBMR Plus 2026: FRAXplus adjustments versus FRAX in the Swiss Osteoporosis Registry (PubMed 42689245)
- 2026: ten-year re-validation of FRAX in Taiwan (PubMed 42479104)
- Calcified Tissue International 2026: missed opportunities before hip fracture (PubMed 42667370)
FAQ
The answers below draw on the sources cited in this guide, and the app they mention is Osteoporosis Journey (by Health Journey Labs).
What is FRAX in plain terms?
As the Bone Health and Osteoporosis Foundation puts it, FRAX is a calculator that combines bone density, age, sex, height, weight and a few questions to estimate fracture chances over the next 10 years. Your clinician explains what the printed result means for your own situation.
Entries for each input kept in Osteoporosis Journey mean the facts behind the estimate are already dated and in one place, ready to hand over when the clinician asks what went into the number.
What goes into a FRAX estimate?
The foundation lists bone density, age, sex, height, weight and answers to 7 questions. Which questions are asked and how answers are entered is the clinician's task, and a written record of your own facts makes those answers easier to give accurately and completely at the visit.
With height, weight and any new fracture dated in Osteoporosis Journey, you have something to read from when the questions come, so the answers match what actually happened and the clinician can see which facts are recent.
Why does a fracture score cover 10 years?
Over a 10-year window, per the foundation, the calculator gives chances of fractures, which makes it a long-range estimate rather than a forecast for the coming week. Your clinician explains how that window fits your history and any later scans.
Lines kept in Osteoporosis Journey across several months show how the inputs have moved inside that long window, which is far easier to see on a timeline than to reconstruct from memory.
Where does the bone density number come from?
The FRAX page says the reference site is DXA at the femoral neck, and the T-score uses reference values for young adult women. A clinician reads that number from your report and enters it for you.
The report date and the printed T-score entered in My Labs of Osteoporosis Journey keep the number tied to the scan that produced it, so a later estimate can be matched to the right report.
Can FRAX be calculated when no DXA scan result is available?
A 2026 hip fracture paper estimated risk from clinical risk factors only, so the calculation can run when a scan result is missing. Whether a scan is advised for you is a clinician decision, and the log only records what has been done and when.
A list of scans and estimates in Osteoporosis Journey, each with a date, shows at a glance which estimates came with a scan result and which were made from clinical facts alone.
What does FRAXplus add?
The Swiss paper says FRAXplus adjusts the 10-year probabilities using extra items such as falls, recent fractures and spine measures. Whether it is used in your clinic is for your clinician to say, and the extra items are easier to supply when they are written down.
Each fall or near-fall entered in the Daily check-in of Osteoporosis Journey supplies one of the extra items such adjustments rely on, with the date and a few words about the setting.
Why do falls matter in a fracture score?
In the Swiss paper, one or more falls and recent spine or hip fractures made the largest differences for individuals. A clinician decides how a fall history enters your estimate, and a dated list helps that conversation start from facts.
A fall list built in Osteoporosis Journey over several weeks lets you read out the count and the settings, which is more reliable than trying to count them in the exam room.
Can a score change between visits?
It can, because the inputs change. The Swiss paper found that adjustments moved the estimates for most people, upward for 72% and downward for 27%. Your clinician decides when a new calculation is worthwhile.
What changed since the last estimate, such as a fall or a new measurement, can be logged in Osteoporosis Journey, which tells the clinician quickly whether a fresh calculation has anything new to use.
What do the 20% and 3% figures mean?
Per the foundation, a 10-year probability of 20% or more for major osteoporotic fracture, or 3% or more for hip fracture, allows a diagnosis of osteoporosis to be made. A clinician applies that to your own numbers and history.
Both printed percentages entered in Osteoporosis Journey with the report date let you compare the next result with the last, and show the clinician the numbers without a search through papers.
Is the online calculator the same as the one on my printout?
The foundation notes that FRAX is built into the software of most DXA systems and is also online. Small differences in inputs can lead to different outputs, so the clinician checks which version produced your printout.
Naming where each estimate came from in Osteoporosis Journey, whether a scan printout or a website, keeps two estimates from being mixed up when a clinician or you compare them months later.
A Taiwan paper says FRAX may underestimate risk. What follows from that?
The paper says FRAX with bone density may underestimate fracture risk, particularly in older adults, which is one reason clinicians read it alongside the whole picture of health and function. How that applies to you is a clinician matter, and a written record supplies some of that picture.
Writing down falls, fractures and everyday function between visits in Osteoporosis Journey gives the clinician the wider picture that the paper suggests should accompany any score, in dated lines that are quick to read.
Who explains my number to me?
Whoever ordered the scan and knows your history explains it, usually the one managing your bone health. A written list of questions helps keep the conversation on what you want to understand, and the answers can be noted as they are given.
Questions filed under the clinician's name in My Care Team of Osteoporosis Journey stay together with the answers given, so the next visit starts from the last one instead of from a blank page.
Can an AI chat interpret a FRAX percentage?
A clinician needs your measured inputs and your history to interpret a score, so the number itself belongs with them. An AI chat can help tidy notes and word questions for that visit, and an injury that looks serious calls for emergency care first.
After the entries are filed in Osteoporosis Journey, a companion can help shape a question list from them, while the interpretation of any number stays with your clinician and the full history.
How far back should the log go?
Back to the last estimate or scan you can date with confidence. The sources set no look-back period, so your clinic's preference decides, and approximate dates marked with a question mark are acceptable to most clinicians.
Older falls and fractures can be added to Osteoporosis Journey with approximate dates and a question mark, which is more useful to a clinician than leaving a gap in the timeline.
How do I keep privacy in check with my health log?
Fall notes, fracture history and medicines are often managed together with a parent or caregiver. Agree on who can read the record, keep it behind a passcode, and print only what the bone health visit needs.
Entries in Osteoporosis Journey belong to you as health notes. Its privacy policy describes how data is stored and handled; check it before you decide what to record. Nothing here is medical advice.