Standard Guidelines: What Age Should I Start DEXA Scans?
The timing for your first Dual-Energy X-ray Absorptiometry (DEXA) scan depends largely on your gender and overall health profile. Health organizations provide clear guidelines for when most people should begin screening, designed to catch potential bone density issues before a fracture occurs.
Recommendations for Women
For women, the U.S. Preventive Services Task Force (USPSTF) recommends routine bone density testing starting at age 65. However, screening may start earlier for postmenopausal women who are under 65 but have certain risk factors that increase their likelihood of osteoporotic fractures. A clinical risk assessment can help determine if earlier screening is necessary.
Recommendations for Men
Men typically develop a higher peak bone mass and lose it more slowly than women, though their fracture risk increases with age. The USPSTF currently notes insufficient evidence for routine screening in men but many other medical societies, including the Endocrine Society, recommend DEXA scans for men aged 70 and older. As with women, men with significant risk factors may also require earlier screening.
Risk Factors That May Necessitate Earlier Screening
Age isn't the only factor dictating when to get a DEXA scan. Several other risk factors can indicate a need for earlier screening, regardless of your gender. Discussing your personal risk profile with your healthcare provider is the best way to determine the right time for you to begin.
Key Risk Factors
- Body Frame: A low body weight (under 127 lbs) or a small body frame is a significant risk factor.
- Family History: A parental history of hip fractures increases your own risk.
- Lifestyle Choices: Smoking and excessive alcohol consumption (more than two drinks per day) are proven to contribute to bone loss.
- Medications: Prolonged use of certain medications, such as corticosteroids, some cancer treatments, and even some acid reflux drugs, can weaken bones.
- Medical Conditions: Chronic illnesses like rheumatoid arthritis, celiac disease, inflammatory bowel disease, and liver or kidney disease can increase osteoporosis risk.
- Hormonal Changes: For women, premature or non-estrogen-supported menopause is a factor. For men, low testosterone levels can be a concern.
- Previous Fractures: A fracture that occurs from minimal trauma, known as a fragility fracture, is a strong indicator.
The DEXA Scan: What to Expect
A DEXA scan is a quick, non-invasive procedure. Understanding the process can help alleviate any anxiety before your appointment.
- Preparation: You may need to stop taking calcium supplements for 24 hours before the scan and should avoid wearing jewelry.
- Procedure: You will lie comfortably on a padded table. The scanner will pass over your body, typically focusing on your hip and spine, as these areas are most indicative of overall bone health.
- Duration: The entire process usually takes only 10 to 20 minutes.
- Low Radiation: The scan uses a very low dose of radiation, far less than a standard chest x-ray.
Deciphering Your DEXA Results: T-Scores vs. Z-Scores
Your DEXA scan results will include a T-score and potentially a Z-score. It's important to understand what these values mean and how they influence your treatment path.
| Score Type | Used For | Comparison Group | Meaning of Result |
|---|---|---|---|
| T-score | Postmenopausal women and men aged 50 and older | A healthy young adult of the same sex | Normal: -1.0 or higher. Osteopenia: between -1.0 and -2.4. Osteoporosis: -2.5 or lower. |
| Z-score | Premenopausal women and men under 50 | Others of the same age, weight, sex, and ethnicity | A score below -2.0 may indicate that bone loss is happening more rapidly than in your peers. |
The Role of the FRAX Tool
In addition to the DEXA scan, your doctor may use a tool called FRAX (Fracture Risk Assessment Tool) to evaluate your 10-year probability of experiencing a hip or other major osteoporotic fracture. FRAX combines your bone mineral density (BMD) with other personal risk factors, providing a comprehensive assessment. This helps your healthcare provider make the most informed decision about whether preventive medication is needed.
Beyond the Scan: Taking Control of Your Bone Health
Regardless of your age or scan results, there are actionable steps you can take to strengthen your bones and reduce fracture risk.
Lifestyle Adjustments
- Exercise: Incorporate weight-bearing exercises like walking, jogging, and weightlifting. These activities help stimulate bone growth.
- Nutrition: Ensure adequate intake of calcium and Vitamin D through diet and supplements. These nutrients are essential for building and maintaining strong bones.
- Avoid Harmful Habits: Limit or quit smoking and excessive alcohol consumption, as both weaken bones over time.
When to Consider Follow-Up Scans
For those diagnosed with osteopenia or osteoporosis, or those receiving treatment, follow-up DEXA scans are crucial. Scans are generally repeated every two years to monitor treatment effectiveness and track changes in bone density, allowing for timely adjustments to your care plan if necessary.
For more in-depth, authoritative information on osteoporosis and bone density testing, consider visiting the official Centers for Disease Control and Prevention website, specifically their page on Facts About Bone Density.
Conclusion
Figuring out what age should I start DEXA scans involves a personalized approach, but standard guidelines offer a reliable starting point. Routine screening at 65 for women and 70 for men is the norm, but individual risk factors can — and often do — accelerate this timeline. By understanding your risk profile, discussing options with your doctor, and taking proactive lifestyle steps, you can secure a stronger, healthier future for your bones.
