What age should you get a bone density test? Latest guidelines

Approximately 54 million Americans are affected by osteoporosis and low bone mass. Because it is a silent disease, knowing what age should you get a bone density test is the first critical step toward preventing debilitating fractures and ensuring healthy aging.

Quick Summary

Healthcare guidelines recommend routine bone density screening for all women aged 65 and older and all men aged 70 and older, with earlier testing necessary for individuals with specific risk factors for bone loss, regardless of age.

Key Points

• Screening ages: Routine bone density screening is recommended for all women aged 65 and older, and for men aged 70 and older.

• Test early if you have risk factors: Younger individuals with specific risk factors like a prior fracture, low body weight, or certain medical conditions should be screened earlier.

• Understand your T-score: A DEXA scan produces a T-score; a score of -2.5 or lower indicates osteoporosis, while -1.0 to -2.5 indicates osteopenia.

• DEXA is the gold standard: The dual-energy X-ray absorptiometry (DEXA) scan is the most accurate test for measuring bone mineral density.

• Osteoporosis is preventable: Early detection through screening allows for timely interventions, including lifestyle changes and medication, to strengthen bones and prevent fractures.

• Risk factors increase with age: Bone loss naturally accelerates in women after menopause and in men as they age, making consistent monitoring important for older adults.

Official Recommendations for Bone Density Screening

The age for a bone density test, or DEXA scan, depends on several factors, including gender and the presence of risk factors. Following these evidence-based guidelines is crucial for proactive bone health management.

Screening Recommendations for Women

Routine bone density screening is recommended for all women aged 65 and older. For postmenopausal women under 65, earlier screening may be recommended if they have one or more risk factors for osteoporosis. Tools like FRAX® can help assess fracture risk.

Screening Recommendations for Men

Many organizations recommend routine DEXA screening for all men aged 70 and older. For men aged 50–69 with significant risk factors, screening is also advised. The USPSTF notes insufficient evidence for routine screening in men but suggests clinicians consider those with risk factors.

Who Needs Earlier Testing? Key Risk Factors

Younger postmenopausal women and men under 70 should discuss a DEXA scan with their doctor if they have risk factors such as:

• A prior fracture after age 50.
• Low body weight or BMI.
• Family history of osteoporosis.
• Long-term use of certain medications (e.g., corticosteroids).
• Medical conditions (e.g., rheumatoid arthritis, diabetes, liver/kidney disease).
• Smoking or excessive alcohol consumption.
• Early menopause or low testosterone in men.

The DEXA Scan: What to Know

A DEXA (or DXA) scan is the gold standard for diagnosing bone loss. This non-invasive, quick test measures bone density, typically in the hip and lower spine.

Preparing for Your Scan

1. Avoid calcium supplements for 24 hours before the test.
2. Wait 7 days after certain procedures involving contrast dye.
3. Wear comfortable clothes without metal.
4. Inform your doctor if you could be pregnant due to low-dose radiation.

Deciphering Your T-Score

Your T-score compares your bone density to a healthy young adult.

T-Score Result	Interpretation	Meaning	Next Steps
-1.0 and above	Normal bone density	Bones are healthy	Maintain lifestyle, periodic rescreening
-1.0 to -2.5	Low bone mass (osteopenia)	Increased fracture risk	Monitor, consider preventative lifestyle changes
-2.5 and below	Osteoporosis	Significantly increased fracture risk	Treatment plan, medication, lifestyle changes

A diagnosis of osteoporosis is based on the lowest T-score in any measured area.

Taking Action for Healthy Bones

If your DEXA scan shows osteopenia or osteoporosis, your doctor will recommend a plan to reduce fracture risk. This may include dietary changes, calcium and vitamin D supplements, weight-bearing exercise, and possibly medication. Follow-up scans are also important. More information is available from the Bone Health and Osteoporosis Foundation.

Conclusion

Knowing what age should you get a bone density test is crucial. While routine screening is recommended for women 65+ and men 70+, risk factors may necessitate earlier testing. DEXA scans are vital for early detection and intervention, helping to prevent fractures and maintain quality of life as you age.

Frequently Asked Questions

What is a DEXA scan?

A DEXA scan, or dual-energy X-ray absorptiometry, is a quick and painless medical test that uses low-dose X-rays to measure the mineral content and density of your bones, most commonly in the hip and spine.

Are bone density test recommendations different for men and women?

Yes, standard guidelines recommend screening for women starting at age 65 and for men starting at age 70. However, individuals with specific risk factors may need to be tested earlier, regardless of gender.

What are some common risk factors for osteoporosis?

Common risk factors include a family history of osteoporosis, low body weight, certain medical conditions (like rheumatoid arthritis or thyroid disease), long-term use of specific medications, and lifestyle choices such as smoking or excessive alcohol use.

What does a T-score of -2.5 or lower mean?

A T-score of -2.5 or lower on a DEXA scan indicates that you have osteoporosis. This means your bone mineral density is significantly lower than that of a healthy young adult, placing you at a higher risk for fractures.

How often should you get a bone density test?

The frequency of follow-up tests depends on your initial results and overall health. For women with normal bone density, tests may only be needed every 15 years, while those with osteopenia or osteoporosis may need more frequent monitoring, often every two years, to track progress.

Is it possible to have osteoporosis in some bones but not others?

No, a diagnosis of osteoporosis is based on the lowest T-score recorded at any site (hip, spine, etc.). The general rule is that if you have osteoporosis in one area, it is considered a systemic condition throughout the skeleton.

Can lifestyle changes improve bone density?

Yes, lifestyle changes, including adequate calcium and vitamin D intake and regular weight-bearing exercise, are important for maintaining and improving bone health. In many cases, these are combined with medication for optimal results.