HealthWatch: Bone Density Tests Need Not Be As Frequent

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SAN FRANCISCO (CBS 5) – A new study on osteoporosis screening published in The New England Journal of Medicine suggests that for older women with normal bone mineral density (BMD) or mild osteopenia, a screening interval of 15 years will miss few new cases of osteoporosis.

UCSF Epidemiologist Dr. Dennis Black is pleased with the report, saying “I think this is really good news for women because it suggests that if you are screened and you are normal, that you can wait a longer interval before you are screened again. So it just makes things easier, less stressed, less worry.”

Researchers tracked some 5,000 women aged 67 or older over a 15-year period. They found it would take roughly one year for a woman with advanced osteopenia to transition to osteoporosis, 5 years for those with moderate osteopenia, and 17 years for those with mild osteopenia or normal BMD.

He said it shows what a good screening test this is, adding “it’s really good at identifying people at high risk of fracture so it is really important that women and to some extent men have bone density tests to assess their risk of fracture.”

Getting screened is key, because with osteoporosis you don’t have any symptoms until you have a fracture. And a fracture can be devastating. “A person who has a hip fracture who is living on their own, has only about a 50% chance of being able to live on their own a year after that hip fracture,” said Black.

But fractures can be prevented. To keep your bones healty, get plenty of weight-bearing exercise. This will keep you limber and could improve the bone itself, but will certainly reduce the risk of falls which can result in fractures. Balance exercises like Tai Chi and yoga will also help reduce the risk of falls. In addition eat a healthy diet with sufficient calcium and be sure to get enough vitamin D either from being in the sun or taking vitamin D supplements.

So is it a good idea to spread out the screening tests? Dr. Black says yes. “I think if you’re really normal and there’s not intervening events such as a disease that causes you to be in bed or some other kind of problem, I would be very comfortable not having another test in two years and waiting five years or seven years,” Black said.

He explained that it’s a very rational use of a screening test, adding “it’s a trend that we are seeing in other areas such as mammography where they are saying if you’re really normal maybe you can wait longer to have your next test.”

NEJM article:
http://www.nejm.org/doi/full/10.1056/NEJMoa1107142

Risk Calculator:
http://www.sheffield.ac.uk/FRAX/

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