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Bone density: How often should you screen?

September 24, 2013 12:00:00 AM PDT
When an elderly person falls and breaks a hip or any other bone, it can be painful and debilitating. In the United States, doctors use routine scans to keep track of your bone health, but how often should you screen? A new report says you may not need as many as you think.

Two years ago, 73-year-old Liz Toon was hiking in the woods with her family when she fell and broke her shoulder.

"I thought I'd done everything right to not break any bones," said Toon.

"Oftentimes, people with osteoporosis don't even recognize that they have osteoporosis until they fall," said Sarah D. Berry, M.D., M.P.H., Institute for Aging and Research, Hebrew SeniorLife.

One way physicians can screen for osteoporosis and assess fracture risk is with a bone-mineral-density test or a DEXA scan.

"We believe that getting the first DEXA scan is important, but it's less clear whether getting a repeat DEXA scan is helpful," said Berry.

In a report provided by the Journal of the American Medical Association, researchers examined 800 senior men and women participating in the Framingham Osteoporosis Study. Each received two DEXA scans about four years apart. Study authors say the second one didn't tell doctors any more than the first one.

"We found that the first DEXA screening test did a very good job of identifying individuals that were likely to go on and break a bone," said Berry.

Presently, Medicare pays for a DEXA scan every two years and has no restriction on the number of repeat tests allowed.

"We would hope that in the future that resources would be used more judiciously so that more elderly persons are getting a first DEXA screening test and fewer persons are getting a repeat DEXA screening test," said Berry.

Toon knows she's prone to more fractures, but it won't stop her from staying active.

"I just keep walking and climbing mountains, and I'll be skiing this winter," said Toon.

In general, bone-mineral-density testing is recommended for women 65 and older and men 70 and older and earlier for those with a family history. Other important information for screening includes your age, weight, whether you smoke, drink alcohol and if you've had previous fractures.


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