[Primary fracture prevention through the Osteoporosis Liaison Service.]

It is difficult to prevent primary fragility fractures because the subjects have not yet experienced a fracture. The offers of the community Osteoporosis Liaison Service are important for primary prevention of fragility fractures. The prevention, education, enlightenment, and the offer of osteoporosis examinations are included in this service. It is necessary to deliver the prevention services and osteoporosis education according to the age of the subjects. Hence, for young people, it is effective to include in school education that getting high peak bone mass is important, and for the middle-aged population, it is necessary to include education on the maintenance of bone quantity and the impact on risk factors such as smoking and excessive alcohol consumption. Furthermore, early detection of osteoporosis is important, with an osteoporosis check-up being one of the few opportunities for assessing the bone mineral density(BMD)in elderly women. However, there are some problems with osteoporosis check-ups in Japan. First, the implementation and participation rates of osteoporosis check-ups are low. Second, only BMD is set as the most important value for the assessment. Third, the subjects are limited to women in the range of 40-70 years of age with the knot age set at every 5 years. Finally, the setting of the BMD measuring apparatus is low. We adopted Fracture Risk Assessment Tool(FRAX)and loco-check for check-ups at Asahi-machi in the Toyama Prefecture to resolve the above problems and have reported its usefulness. Action by the Osteoporosis Liaison Service to enforce osteoporosis check-ups is expected. Various types of professional medical staff participate in the Osteoporosis Liaison Service as osteoporosis managers. It is desired that the managers will cooperate and function as an osteoporosis project team in the community.