How often should seniors get a DEXA scan? Understanding bone density guidelines

Oct 30, 2025 3 min read •

Senior Health Osteoporosis Medical Testing

According to the Bone Health and Osteoporosis Foundation, one in two women and up to one in four men aged 50 and older will break a bone due to osteoporosis. This highlights the critical importance of knowing how often should seniors get a DEXA scan to monitor bone density and prevent fractures. The appropriate screening interval varies based on a person's age, gender, and individual risk factors.

Quick Summary

Bone density screening frequency for seniors is determined by age, gender, prior results, and risk factors. Initial scans are recommended for women 65+ and men 70+, with follow-up intervals varying from 1 to 10 years based on bone density and risk profile. Medicare generally covers scans every 24 months, with medically necessary exceptions.

Key Points

Age and Gender Guidelines: Standard recommendations suggest a baseline DEXA scan for women at age 65 and for men at age 70.
Normal Result Frequency: For seniors with a normal T-score and no risk factors, repeat testing may only be needed every 5 to 10 years.
Osteopenia Monitoring: Seniors with osteopenia should get more frequent scans, typically every 2 to 5 years, to monitor for progression.
Osteoporosis Monitoring: For those diagnosed with osteoporosis or undergoing treatment, scans are generally recommended every 1 to 2 years.
Risk Factors Trigger Earlier Screening: Medical conditions, certain medications, low body weight, prior fractures, and family history can all lead to earlier or more frequent screening.
Medicare Coverage: Medicare Part B covers DEXA scans every 24 months for eligible individuals and more often if medically necessary and documented.
Individualized Approach: The precise frequency should always be determined by a healthcare provider based on your specific health profile and risk factors.
Consistency for Accuracy: For comparison purposes, it is best to have follow-up scans performed at the same testing facility.

A Dual-Energy X-ray Absorptiometry (DEXA) scan is the gold standard for measuring bone mineral density (BMD) and diagnosing osteoporosis. For seniors, understanding the right frequency for these scans is a crucial part of proactive health management. While general guidelines exist, the best approach is always a personalized one, determined in consultation with your healthcare provider. The frequency depends heavily on your initial scan results and risk factors.

Standard DEXA Scan Recommendations for Seniors

Guidelines from organizations like the U.S. Preventive Services Task Force (USPSTF) and the Bone Health and Osteoporosis Foundation (BHOF) provide recommendations for when to start screening. For women, screening is typically recommended starting at age 65. If the initial scan is normal and there are no significant risk factors, a repeat scan may not be needed for 10 years. For men, routine screening is generally advised starting at age 70, although those with risk factors may begin earlier. Follow-up intervals for both men and women are adjusted based on initial results and individual risk profiles.

Determining Frequency Based on Initial DEXA Results

Initial DEXA scan results, particularly the T-score, significantly influence the recommended follow-up schedule. A normal T-score (above -1.0) with no other risk factors may mean a repeat scan is only needed every 5 to 10 years. If the T-score indicates osteopenia (between -1.0 and -2.5), closer monitoring is required, typically with repeat scans every 2 to 5 years. For individuals diagnosed with osteoporosis (T-score of -2.5 or lower), more frequent scans, often every 1 to 2 years, are recommended to monitor bone density and the effectiveness of treatment.

Risk Factors That Affect DEXA Scan Frequency

Certain risk factors can necessitate earlier or more frequent DEXA scans. These include specific medical conditions such as chronic kidney disease, rheumatoid arthritis, and primary hyperparathyroidism, as well as long-term use of certain medications like corticosteroids. A history of fractures after age 50 or a parental history of hip fracture also increases risk. Lifestyle factors like low body weight, smoking, and excessive alcohol consumption are also relevant.

Comparison of DEXA Scan Frequency Based on Risk Profile


Risk Profile	General DEXA Scan Frequency	Factors Influencing Frequency
Low Risk	Every 5 to 10 years	Normal T-score, no significant risk factors.
Moderate Risk	Every 2 to 5 years	Osteopenia (T-score between -1.0 and -2.5), some risk factors present.
High Risk	Every 1 to 2 years	Diagnosed osteoporosis, ongoing treatment, steroid use, multiple risk factors.

The Role of Medicare in DEXA Scan Coverage

Medicare Part B typically covers bone density tests, including DEXA scans, every 24 months for eligible individuals. Eligibility criteria include being an estrogen-deficient woman at clinical risk, having X-rays indicating bone issues, taking or planning long-term steroid therapy, having primary hyperparathyroidism, or being monitored for osteoporosis drug effectiveness. Medically necessary scans more frequent than every 24 months may also be covered if documented by your doctor. Patients with Medicare Advantage plans should confirm coverage details with their specific plan.

Conclusion

Determining how often should seniors get a DEXA scan is a personalized decision based on age, gender, initial scan results, and individual risk factors. While guidelines exist, ranging from initial scans for women at 65 and men at 70 to follow-ups every 1 to 10 years depending on bone density and risk, consulting with a healthcare provider is essential to establish the most appropriate screening schedule. Proactive monitoring through DEXA scans is a key component in preventing fractures associated with bone loss.

A Note on Monitoring

For accurate comparison of results over time, it is generally recommended to have follow-up DEXA scans performed at the same testing center as the original scan. The data from these consistent scans, combined with clinical assessment, helps guide treatment and lifestyle adjustments to protect bone health.

Frequently Asked Questions

For women, the U.S. Preventive Services Task Force recommends a first DEXA scan at age 65. For men, screening typically begins at age 70, though risk factors can lead to earlier testing for both genders.

Yes, if you have osteopenia (low bone mass), you will need more frequent monitoring than someone with normal bone density. Doctors usually recommend repeat scans every 2 to 5 years to track bone loss and assess risk.

Seniors with a diagnosis of osteoporosis, or those receiving treatment, should get scans more frequently. The standard recommendation is typically every 1 to 2 years to monitor the disease and the effectiveness of medication.

Yes, Medicare Part B generally covers a bone density DEXA scan once every 24 months for eligible individuals. More frequent testing may be covered if it is deemed medically necessary by a doctor.

Risk factors include a prior fracture after age 50, long-term use of corticosteroid medications, low body weight, a family history of osteoporosis, smoking, and certain medical conditions like rheumatoid arthritis.

DEXA scans use very low levels of radiation, significantly less than a standard X-ray. While radiation exposure is cumulative, the amount is minimal, and the diagnostic benefits for at-risk seniors typically outweigh any potential risks. Your doctor will determine the safest, most effective interval for you.

Yes, if you have risk factors for osteoporosis or a family history of fractures, your doctor may recommend a baseline DEXA scan earlier. Always discuss your concerns and family history with your healthcare provider.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.