What Age Should I Get an Osteoporosis Test?: Guidelines and Risk Factors

As many as one in two women and up to one in four men over 50 will break a bone due to osteoporosis. This makes understanding what age should I get an osteoporosis test a crucial step in preventative healthcare for many adults and a vital conversation to have with your doctor.

Quick Summary

For women, screening typically begins at age 65, and for men, age 70, though earlier testing may be recommended if specific risk factors are present. Consult your doctor to determine the right time for your DEXA scan.

Key Points

• Standard Age for Women: Women should typically be screened for osteoporosis starting at age 65, or earlier if postmenopausal with risk factors.

• Standard Age for Men: Many organizations recommend screening men starting at age 70, though guidance can vary, and earlier testing may be needed with risk factors.

• Know Your Risk Factors: Key factors like family history, premature menopause, certain medications, and a low body mass index can prompt earlier testing.

• The DEXA Scan: This quick and painless procedure is the standard for measuring bone mineral density and diagnosing osteoporosis.

• Don't Wait for Symptoms: Osteoporosis is often a silent disease, so proactive screening before a fracture occurs is crucial.

• Talk to Your Doctor: Your healthcare provider can assess your individual risk using a formal tool and recommend the best screening schedule for you.

Official Screening Guidelines for Women

The U.S. Preventive Services Task Force (USPSTF) recommends bone density testing using a dual-energy X-ray absorptiometry (DEXA) scan for all women aged 65 years and older. Screening is also recommended for postmenopausal women under age 65 who have increased risk factors for an osteoporotic fracture, utilizing a clinical risk assessment tool.

Official Screening Guidelines for Men

While the USPSTF states there is insufficient evidence for routine screening in men, other organizations like the Bone Health and Osteoporosis Foundation suggest screening for men starting at age 70. Earlier screening may be advised for men with specific risk factors based on a doctor's clinical judgment.

Key Risk Factors that Signal Earlier Screening

Several factors can increase osteoporosis risk and warrant earlier testing. These include non-modifiable factors like genetics, family history of hip fracture, age, gender (women, especially postmenopausal, are at higher risk), a small body frame, and ethnicity. Modifiable risks include smoking, excessive alcohol, inadequate calcium and vitamin D, and a sedentary lifestyle. Additionally, certain medical conditions (hyperthyroidism, celiac disease, etc.) and long-term use of some medications (steroids, anticonvulsants) can increase risk.

Understanding the DEXA Scan

The DEXA scan is the primary method for diagnosing osteoporosis and assessing fracture risk. This simple, low-dose X-ray measures bone density, typically in the spine and hip. Results are given as a T-score, comparing your density to a healthy young adult:

• 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.

Bone Density Testing Comparison

Feature	Standard Age-Based Testing	Risk Factor-Based Testing
Initiating Factor	Reaching the recommended age milestone (e.g., 65 for women).	Presence of one or more osteoporosis risk factors.
Target Population	General population of women 65+ and men 70+.	Postmenopausal women under 65 and men under 70 with identified risks.
Goal	Proactive screening to detect bone loss before fractures occur.	Early intervention for individuals with higher-than-average risk.
Assessment Tool	Age alone is the primary trigger.	Clinical risk assessment tools (e.g., FRAX) are used.

How to Discuss Osteoporosis Testing with Your Doctor

Discuss your bone health with your doctor by sharing your family history of osteoporosis, any past fractures, and your medical history. Provide a list of all medications, describe your diet and exercise habits, and discuss smoking or alcohol use. If you are a postmenopausal woman under 65 or a man approaching 70 with risk factors, ask for a formal risk assessment to see if earlier screening is right for you.

For detailed information on diagnosis, prevention, and treatment, consult the Bone Health and Osteoporosis Foundation.

Conclusion: Taking Control of Your Bone Health

Preventative screening for osteoporosis is a key part of healthy aging. While age guidelines provide a starting point, personal risk factors are crucial for determining when to test. Discussing your individual risk with your doctor allows for informed decisions to protect your bones and maintain quality of life.

Frequently Asked Questions

What is the standard recommended age for women to get an osteoporosis test?

The U.S. Preventive Services Task Force recommends routine osteoporosis screening for women starting at age 65. Earlier screening is advised for postmenopausal women under 65 with risk factors.

When should men consider getting an osteoporosis test?

While recommendations vary, many medical organizations suggest men consider screening starting at age 70. However, men with significant risk factors may need to be tested earlier.

What are the main risk factors that would prompt earlier screening?

Risk factors for earlier testing include having a family history of osteoporosis, a previous fracture from a minor fall, premature menopause, low body weight, or long-term use of certain medications like steroids.

What happens during a bone density or DEXA scan?

A DEXA scan is a quick, non-invasive procedure where you lie on a table while a low-dose X-ray machine scans your hip and spine. The entire test typically takes less than 20 minutes.

What does a T-score result on a bone density test mean?

A T-score compares your bone density to that of a healthy young adult. A score of -1.0 or higher is normal, a score between -1.0 and -2.5 indicates osteopenia (low bone mass), and a score of -2.5 or lower indicates osteoporosis.

If I have osteopenia, do I need treatment?

Not necessarily. Osteopenia means low bone mass but not osteoporosis. Your doctor will use a fracture-risk assessment tool (like FRAX) to determine your 10-year fracture risk. If the risk is high, treatment might be recommended even with osteopenia.

How often should a bone density test be repeated?

The frequency depends on your initial results and risk factors. Some guidelines suggest repeating the DEXA scan every two years if you have osteoporosis, while longer intervals may be recommended for those with normal or low bone mass.