Test My Bones, Please

Osteoporosis expert encourages bone density testing at 65 for women

(RxWiki News) Did you know that your bones are at their peak in your late twenties and early thirties? By the time you're in your sixties, it's time to get your bones checked.

A new study has found that how strong your bones are when you hit age 65 is a good determinant of whether you'll have good bone health through the rest of your life.

But not enough women are getting tested, according to researchers, and they may be missing out on the preventative care that can help them avoid painful fractures.

"If you're 65 and a woman, get a bone mineral density test."

Dr. Margaret Gourlay is a professor of family medicine at the University of North Carolina, Chapel Hill, and the lead author of the study. She's been studying osteoporosis and bone density for over a decade, and she spoke with daily Rx about why it's so important to get a bone density test.

“Bone density testing is best predictor we have of fractures. The whole purpose of screening for osteoporosis is that you can give those patients medicines, and reduce the rates of fractures,” Dr. Gourlay said.

Dr. Gourlay said the most dangerous type of fractures are hip and spine fractures, which are most likely to occur when the bones are extremely fragile.

She said that medication – typically bisphosphonates – can reduce the risk of these fractures by as much as fifty percent. But first, a patient has to be tested.

The purpose of Dr. Gourlay's study was to contribute to research that may inform guidelines for bone density testing. Currently, there's general agreement that all women over 65 should be tested, and some women who have high risk factors should be tested between 60 and 64.

But how frequently should they take the test, after 65?

“There has not been a specified time between tests, which is why we did this study,” Dr. Gourlay explained. “We wanted to know for everyone from really good bone density range down to the thinnest range - close to having osteoporosis - how long did it take for them to develop osteoporosis?”

The study used data from the Study of Osteoporotic Fractures, a long-running study that provided information on 5,000 women. They were divided into four groups based on their score on the bone density test at age 67.

The bone density test provides a score that compares the individual's bone density to a “normal” bone density, that of a 20 to 30 year old at peak bone mass.

A low score means you are close to osteoporosis, while a score closer to the norm means you have healthy bones.

They looked at how long it took 10 percent of the women in each group to develop osteoporosis.

“What we did not expect – it was quite a surprise – was that the top two groups, the normal and mild groups, were so different [from the moderate and advanced groups],” she said.

It took fifteen years for 10 percent of the mild and normal groups fifteen years to develop osteoporosis, compared to five years for moderate osteopenia and one year for advanced osteopenia.

The bottom line, Dr. Gourlay said, is “If you get to age 67 and over, and your first bone density test has good scores, you're less likely to need the test in say in about 5 years than someone who has lower scores.”

She emphasized that women should be tested at 65, whether their doctors remember to offer the test or no. The test can go a long way towards preventing painful fractures and costly medical expenses later in life, she said.

The study was published in the New England Journal of Medicine in January 2012.

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Review Date: 
January 18, 2012