Should a 70 year old man get a bone density test? Expert guidelines explained

While osteoporosis is often considered a women's health issue, an estimated one in four men over 50 will suffer an osteoporosis-related fracture. This statistic underscores why the question, should a 70 year old man get a bone density test, is so important for proactive senior health.

Quick Summary

Yes, many health organizations recommend that all men 70 and older consider a bone density test, with screening advised even earlier for those with specific risk factors. The decision should be made in consultation with a doctor to evaluate personal health and lifestyle factors.

Key Points

• Screening is Recommended: Many expert bodies, like the National Osteoporosis Foundation and Endocrine Society, recommend routine bone density testing for all men aged 70 and older.

• Age is a Major Factor: As men age, bone density naturally decreases, increasing the risk of osteoporosis and fractures by age 70.

• Consider Risk Factors: A bone density test may be advised for men between 50 and 69 if they have other risk factors, including low testosterone, long-term use of certain medications, or previous fractures.

• The Test is Quick and Painless: The DXA scan is a simple, non-invasive procedure that uses low-dose X-rays to measure bone mineral density, typically focusing on the hip and spine.

• Results Guide Next Steps: The T-score from a DEXA scan helps determine if you have normal bone density, osteopenia, or osteoporosis, which guides treatment decisions with your doctor.

• Lifestyle Changes Help: A healthy diet rich in calcium and vitamin D, regular weight-bearing and strength-training exercise, and avoiding smoking and excessive alcohol are key for managing and preventing bone loss.

Osteoporosis in men: The need for screening

For decades, osteoporosis has been primarily associated with postmenopausal women. However, bone loss is a natural part of aging for both sexes. By age 70, a man's risk of osteoporosis and related fractures increases significantly, making a bone density test a critical component of preventative care. While some health groups differ on the necessity of routine screening, many leading organizations like the National Osteoporosis Foundation and the Endocrine Society strongly recommend it for men aged 70 and older. This proactive step is crucial for identifying bone mineral density issues before a debilitating fracture occurs.

Comparing guidelines: When to get tested

There is no single consensus on routine screening for all men, so understanding the different guidelines is important. While the U.S. Preventive Services Task Force (USPSTF) notes insufficient evidence to recommend for or against routine screening, other organizations are more decisive.

Organization	Recommendation for Men	Notes
National Osteoporosis Foundation (BHOF)	Recommends screening for all men 70 years and older.	Advises earlier screening for men aged 50-69 with risk factors.
Endocrine Society	Recommends testing for all men 70 years or older.	Advises testing for men 50-69 with risk factors.
Mayo Clinic	Notes some guidelines recommend testing for men by age 70, especially if risk factors exist.	Acknowledges the USPSTF position while highlighting higher-risk individuals.

Regardless of these variations, a conversation with a healthcare provider is essential for a personalized risk assessment.

Identifying key risk factors in senior men

Age is a primary risk factor, but it's not the only one. Many other factors can accelerate bone loss in men, potentially necessitating a bone density test before the age of 70. These include:

• Lifestyle choices: Long-term tobacco use and excessive alcohol consumption are known to weaken bones and contribute to fracture risk.
• Medical conditions: Certain diseases, such as rheumatoid arthritis, diabetes, chronic kidney disease, and low testosterone levels, increase the likelihood of bone loss. Hypogonadism (low testosterone) is a common cause of secondary osteoporosis in men.
• Medications: Long-term use of corticosteroids (prednisone), certain seizure medications, and treatments for prostate cancer can significantly impact bone density.
• Low body weight: A body mass index (BMI) under 20 kg/m² or low body weight (less than 127 pounds) is a risk factor.
• Family history: Having a parent who has had an osteoporotic fracture, particularly a hip fracture, increases your own risk.
• Previous fracture: Experiencing a fracture after the age of 50 from a minor fall is a strong indicator of weakened bones.

What to expect from a DEXA scan

A bone density test, or DXA (dual-energy X-ray absorptiometry) scan, is a quick, non-invasive, and painless procedure that measures bone mineral density (BMD). It is considered the gold standard for diagnosing osteoporosis. During the test, you will lie on a padded table while a low-dose X-ray machine scans your bones, typically at the hip and spine.

Preparation for the test is simple and includes:

• Wear comfortable clothing: Avoid clothing with metal zippers, buttons, or buckles. You may be asked to wear a gown.
• Avoid calcium supplements: Do not take any calcium supplements, multivitamins with calcium, or other calcium-containing products within 24 hours of your appointment.
• Inform your doctor of prior exams: Let your provider know if you recently had an imaging study that used a contrast dye (like barium or an IV contrast) as it can interfere with results.

Understanding the results: T-scores and next steps

The results of your DEXA scan will be reported as a T-score, which compares your bone density to that of a healthy young adult. The following ranges apply to men aged 50 and older:

• Normal: T-score of -1.0 or higher.
• Osteopenia: T-score between -1.0 and -2.5 (low bone mass).
• Osteoporosis: T-score of -2.5 or lower.

If your test reveals low bone density, your doctor will discuss treatment options. Early detection is key, as medications can help slow bone loss and reduce fracture risk. In addition to potential medication, lifestyle changes are a powerful tool for improving bone health.

Actionable strategies for stronger bones

Regardless of your test results, a proactive approach to bone health is beneficial. The following strategies can help prevent or manage bone loss in senior men:

Diet and supplements

• Increase calcium intake: Aim for 1,200 mg of calcium daily from a combination of food and supplements if necessary. Dairy products, leafy greens, and fortified foods are excellent sources.
• Get enough vitamin D: Adequate vitamin D is essential for calcium absorption. Recommendations for men over 70 are typically 800–1,000 IU daily, often requiring a supplement.
• Ensure sufficient protein: Adequate protein is important for bone density and strength.

Exercise

Regular, weight-bearing exercise is critical for bone health, stimulating bone formation and slowing loss.

• Weight-bearing exercises: Brisk walking, jogging, hiking, dancing, and stair climbing are all effective.
• Strength training: Lifting weights or using resistance bands builds muscle and can improve bone mineral density.

Lifestyle modifications

• Quit smoking: Tobacco use is a major risk factor for bone loss and fractures.
• Moderate alcohol intake: Excessive alcohol consumption can interfere with calcium absorption and increase fall risk.
• Prevent falls: Implement fall prevention strategies, including improving balance with exercises like Tai Chi and making home modifications.

In summary: A vital conversation for your health

For a man aged 70, a bone density test is not just a routine check-up; it's a vital part of protecting against life-altering fractures. Given the consensus among many medical societies, the best course of action is to speak with your doctor about your personal risk factors and determine if a DEXA scan is right for you. Early intervention with lifestyle changes and, if necessary, medication can significantly improve your long-term bone health and quality of life. For more detailed information on bone health and osteoporosis, visit the Bone Health & Osteoporosis Foundation for additional resources and guidance.

Frequently Asked Questions

Does insurance cover a bone density test for a 70 year old man?

Medicare typically covers a bone density test every two years for individuals considered at risk for osteoporosis. Many private insurance plans also offer coverage, but you should check with your provider regarding specific eligibility and frequency.

What is the difference between a DEXA scan and a bone scan?

A DEXA scan measures bone mineral density to assess strength and diagnose conditions like osteoporosis. A bone scan, on the other hand, is a nuclear medicine test used to find bone infections, tumors, or fractures and involves a radioactive substance.

If my T-score shows osteopenia, what should I do?

If your T-score indicates osteopenia, your doctor will discuss strategies to prevent further bone loss and reduce fracture risk. This often includes increasing calcium and vitamin D intake, adopting a weight-bearing exercise routine, and addressing any lifestyle factors like smoking or excessive alcohol.

Can I eat or drink before a DEXA scan?

Yes, you can eat and drink normally before a DEXA scan, but you should not take any calcium supplements for at least 24 hours prior to the test. You should also avoid imaging tests with contrast dye in the days leading up to the scan.

What kind of exercise is best for male bone health?

Weight-bearing exercises, such as brisk walking, hiking, jogging, and resistance training, are excellent for strengthening bones. These activities stimulate bone formation and help maintain density as you age.

Do I need to get tested if I have no symptoms of osteoporosis?

Yes. Osteoporosis is often called a 'silent disease' because it typically has no symptoms until a fracture occurs. This is why screening at age 70 is so important, especially for those with risk factors, to identify and address the issue early.

Are there any risks associated with a DEXA scan?

A DEXA scan uses a very small, harmless amount of radiation, similar to what you receive from daily background radiation. The benefits of detecting bone loss and preventing fractures far outweigh the minimal risks involved.