ARE YOU DUE FOR A BONE DENSITY TEST? SEE THE UPDATED SCREENING GUIDELINES

Are you due for a bone density test? The U.S. Preventive Services Task Force announced updated osteoporosis screening guidelines on January 14, 2025. Women 65 years or older, or postmenopausal women who have one or more risk factors for osteoporosis, should get screened, according to the new guidelines. This painless scan helps determine your bone mineral density (BMD), or the measure of essential minerals like calcium and phosphorus in your bones. The more minerals they contain, the less likely you are to break a bone. Here's everything you need to know to prepare for a bone density scan, plus what the results mean for your health.

How maintaining bone density reduces your risk of osteoporosis

To get a clear picture of how bone density factors into osteoporosis, it helps to know the actual makeup of your bones. They contain two layers of living tissue: the hard outer layer, called the compact or cortical bone, and the spongy inner layer, called the cancellous or trabecular bone. The inner layer resembles a honeycomb and is lighter and less dense than the outer layer. 

When someone has osteoporosis, the holes and spaces are bigger and more porous than a healthy bone, meaning they've lost density or mass, says the Bone Health and Osteoporosis Foundation. A bone with larger hollow spaces is more prone to fractures compared to a dense bone, explains  Faryal Mirza, MD, an endocrinologist, professor of medicine at the University of Connecticut (UConn) School of Medicine and the director of the UConn Center for Osteoporosis in Farmington, CT. 

Bottom line: When bone density is lower, the risk of developing osteoporosis increases. (Learn more about the stages of osteoporosis here.)

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A bone density test can reveal your risk of fractures 

Your doctor may assess your osteoporosis risk by inquiring about past fractures and your family history. But the most reliable way to check bone density is through a bone density test (BDT) or scan.

"A bone density scan is how we typically diagnose osteoporosis and identifies who's at a higher risk of having it," says endocrinologist Marilyn Augustine, MD, an expert in metabolic bone disease and an associate professor in the Department of Medicine at the University of Rochester in Rochester, NY. Because osteoporosis typically doesn't show any symptoms-it's often called a "silent"' condition-people may not know they have it until they have a fracture, says Dr. Augustine. This is why it's important to consider a bone density test before that happens.

When should you get a bone density test? New guidelines

The updated 2025 guidelines for an initial bone density test or scan is for women 65 and older or postmenopausal women at an increased risk of osteoporosis. That includes having one or more factors such as a genetic predisposition, a history of smoking, previous rapid weight loss or having an inflammatory health condition.

That said, getting a bone density test in your fifties can bring some peace of mind. According to the National Institute on Aging, women who are 50 or older are at a higher risk of developing osteoporosis. There are several possible reasons for this, but the biggest culprit is decline in protective estrogen that happens during menopause.

"Estrogen is one of the hormones that helps people to build bone," Dr. Augustine says. "So when estrogen levels drop, it results in bone loss."

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How a bone density test works 

If your doctor thinks you're at risk for osteoporosis, she will likely send you for a bone density test. The one most people have is a dual-energy x-ray absorptiometry (DEXA or DXA) scan, says Dr. Augustine. 

"It's a painless, low radiation x-ray that scans the hip, spine and sometimes the forearm," she says. "We look at the bigger bones because they are better at measuring bone density over time." 

Dr. Augustine says a DEXA scan is quick, lasting about 15 to 30 minutes. In most cases, people don't need to change into a gown and can remain fully clothed. 

Your provider will usually get the results, which come in the form of a T-score, within a few days. "The T-score compares the bone density of the person with that of a healthy young adult," says Dr. Mirza. "The bigger the negative number is how much a person is off from the average bone density (of the reference population)."

What your scan results mean

Your doctor will evaluate your T-score along with your personal medical history to determine your osteoporosis risk. In the meantime, here's what the numbers signal about your bone health:

A T-score of -1.0 or higher indicates your bone density is considered normal. A T-score between -1.0 and -2.4 means your bone density is low and you may be at risk of developing osteoporosis. A T-score of -2.5 or less signals you probably have osteoporosis. 

The next steps will depend on your particular T-score. If your bone density scan results show you're at risk or confirm a diagnosis of osteoporosis, your doctor may start you on a prescription medication such as alendronate (Fosamax), raloxifene (Evista) or an injectable such as denosumab (Prolia). 

If you're concerned about developing weak bones as you age, you might want to consider adopting health habits that can help build your bone density naturally. This can include talking to your doctor about calcium supplements, maintaining a healthy weight and squeezing some weight-bearing exercise into your daily routine.

For more on bone health

Can Osteoporosis Be Reversed? Simple Changes That Prevent Bone Loss

The Benefits of Eating Yogurt Every Day, According to Nutritionists

Enhance Bone Strength and Balance With Online Workouts That Can Help Prevent Osteoporosis

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.

2024-10-10T23:24:43Z