DXA T-score −2.8 (osteoporosis) + sub-cortical white matter ischaemia + MoCA 24 → bisphosphonate + memory-clinic referral same week.
Frances has an obvious bone problem and a quieter brain problem. The fragility fracture is a sentinel event — Z-score-validated. The cognitive softness + Fazekas 2 SVD raises mixed dementia risk; early lifestyle + vascular-risk modification can slow progression by ~40%.
These are the specific levers OCTON puts on your plan — each one comes with the expected impact below.
Lumbar L1-L4 T-score −2.4. Total hip T-score −2.8 (femoral neck −2.9). FRAX 10-year major osteoporotic fracture probability 24%, hip fracture 9.4%. Osteoporosis confirmed by WHO criteria.
Frances came in for an ED-aftercare visit for her wrist fracture. The cubicle picked up the second story her primary problem was hiding: the same vascular risk that drives osteoporosis can drive vascular dementia. One sentinel event, two referral pathways activated. Three years later: zero new fractures, MoCA stable at 25/30, BP optimised, vitamin D 48 ng/mL. The 'wrist fracture' visit added 6 quality-adjusted life-years.
Take the risk questionnaire, upload your scans, and have OCTON build your own preventative plan — same pipeline, your data.