Assessment of the risk of osteoporosis at the menopause: therapeutic consequences.

Osteoporosis prevention programs, based on risk assessment, are an important goal both for individual patients and for improved public health. I have reviewed some of the current approaches to such programs and the major questions which must be answered in order to validate these approaches. In particular, new knowledge concerning the usefulness of markers of bone turnover and of the effectiveness of antiresponsive strategies should greatly improve our ability to prevent osteoporotic fractures. Meanwhile, there is enough information to support the concept that risk assessment should be used to develop a cost-effective prevention program and to guide the approach to therapy.