Which of the following is a risk factor that promotes earlier osteoporosis screening?

• A. Parental history of hip or spine fracture
• B. Regular exercise
• C. BMI 28 kg/m2
• D. Non-smoker

Answer: (A)

Having a parent who has had a hip or spine fracture increases heritable risk for osteoporosis and fragility fractures. This family history raises the likelihood that she will have low bone density, even if she feels well, so clinicians are more inclined to perform bone density screening earlier than the standard age threshold. Detecting reduced bone density early allows timely preventive measures—adequate calcium and vitamin D, weight-bearing exercise, lifestyle changes, and, if needed, osteoporosis medications—to reduce future fracture risk.

Regular exercise, higher body mass index, and not smoking are protective factors that do not push screening earlier; they indicate a lower overall risk, so they don’t justify advancing the screening timeline.