What Should Seniors Know About Bone Density Testing?
Bone density testing measures bone strength and identifies osteoporosis, a condition that significantly increases fracture risk. Understanding bone density testing helps seniors know when to be tested and what results mean for their health.
What Bone Density Testing Measures
Bone density testing, most commonly done with dual-energy X-ray absorptiometry or DEXA scan, measures the mineral content of bones. Higher mineral content means stronger bones less likely to fracture. The test is painless, quick, and uses minimal radiation.
DEXA scans typically measure the spine and hip, sites where osteoporotic fractures commonly occur and cause the most serious consequences. Results indicate bone strength at these critical locations.
Who Should Be Tested
Guidelines recommend bone density testing for all women age 65 and older and men age 70 and older. Earlier testing is recommended for those with risk factors including previous fractures, family history of osteoporosis, low body weight, smoking, excessive alcohol use, and long-term steroid use.
Those with conditions affecting bone health, including rheumatoid arthritis, celiac disease, and hyperparathyroidism, should be tested. Anyone who has had a fracture from minor trauma should be evaluated for osteoporosis.
Understanding Results
Results are reported as T-scores comparing your bone density to that of a healthy young adult. A T-score of -1.0 or above is normal. T-scores between -1.0 and -2.5 indicate osteopenia, or low bone mass. T-scores of -2.5 or below indicate osteoporosis.
The lower the T-score, the greater the fracture risk. Each standard deviation decrease roughly doubles fracture risk. However, T-score alone does not determine treatment. Overall fracture risk considers T-score along with other risk factors.
FRAX Risk Assessment
FRAX is a tool that calculates 10-year probability of major osteoporotic fracture and hip fracture. It incorporates bone density along with age, sex, weight, fracture history, family history, smoking, alcohol use, steroid use, and certain medical conditions.
Treatment decisions often rely on FRAX scores rather than T-scores alone. Treatment is generally recommended when 10-year hip fracture risk exceeds 3 percent or major osteoporotic fracture risk exceeds 20 percent.
If Results Show Osteoporosis
Osteoporosis diagnosis prompts evaluation for underlying causes. Blood tests may identify vitamin D deficiency, calcium abnormalities, thyroid problems, or other treatable conditions contributing to bone loss.
Treatment options include medications that slow bone loss or build new bone. Bisphosphonates are commonly used first-line treatments. Newer medications offer alternatives for those who cannot take or do not respond to bisphosphonates.
Lifestyle measures support bone health regardless of medication use. Adequate calcium and vitamin D intake, weight-bearing exercise, fall prevention, and avoiding smoking and excessive alcohol all contribute to bone health.
Follow-Up Testing
Repeat bone density testing monitors treatment effectiveness or disease progression. Testing is typically repeated every one to two years for those on treatment or with osteoporosis. More frequent testing is rarely useful since bone changes slowly.
Getting Bone Density Testing
All Seniors Foundation encourages appropriate bone density screening. Identifying and treating osteoporosis prevents fractures that threaten independence. Contact us if you have questions about bone health or need help accessing testing.
