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How Often Should You Have a Bone Density Test?

Research reveals that four-year repeat of bone density test in seniors offers limited value

Sarah Berry, M.D., M.P.H's picture
How Often Should You Have a Bone Density Test?
How Often Should You Have a Bone Density Test?

Physicians rely on bone mineral density testing as an important tool in assessing the risks for, and management of, the bone disease called osteoporosis. Although there are no guidelines for the frequency of repeating bone density tests, Medicare pays for screening every two years —without limiting the number of repeat tests, and regardless of the results of the patient's initial (or baseline) bone density scan.

Given the drive to improve health care quality and control costs, we wanted to see if repeating a bone density test is truly useful. A recent study I led showed that performing the test again after four years actually offers little benefit when it comes to assessing bone fracture risk in people age 75 and older.

What this means for patients: The current practice of repeating the bone density scan every two years may not be necessary in older adults who aren’t being treated for osteoporosis. Instead, we recommend that physicians review other possible risk factors patients may have, like age and fracture history, in addition to the first bone mineral density test.

The good news is that our research shows that the initial bone density test does a very good job of identifying people at risk for fracture. The bad news is that only five percent of Medicare beneficiaries age 75 and older have a bone density scan in a given year. The low screening rate shows a lack of public understanding about this very serious condition.

Osteoporosis is called a "silent disease" because people don’t usually know they have it until they have a fracture, and at that point the damage is done. Based on our research, I hope that resources will be used more thoughtfully so that more elders get a baseline bone density test, and fewer get a repeat test in a short time period.

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Research Assistant Scientist II

Dr. Sarah berry obtained her bachelor's degree from Auburn University, her medical degree from the University of Alabama School of Medicine, and her master's degree from the Harvard School of Public Health. She completed her residency in internal medicine at the University of Utah Health Sciences Center and a fellowship in the Harvard Medical School Multi-campus Fellowship in Geriatric Medicine. Dr. Berry, an instructor in medicine at Harvard Medical School, is primarily interested in osteoporosis and outcomes following osteoporotic fractures in the community and nursing home settings. She...

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Comments (3)

The information in this

The information in this article is counter-intuitive, yet it seems to be backed by quality research. You would think that it would be a good idea to keep testing the elderly if their insurance pays for it, but surprisingly the research says otherwise. I bet it would still be useful to get a bone density test every ten years but I could be wrong. It would also be nice to somehow get the word out to get that first bone density test, as many seniors don't get it until the damage is done. Thanks Sarah for sharing this with us.

Whole thing is scary to me as

Whole thing is scary to me as I suffer from male menopause and read conflicting results about everything, I do not abuse any drug prescribed, but feel useless sometimes...lately it seems my whole body is stiff and sore....

I believe that so called

I believe that so called research today regarding falls and bone density in the elderly is geared toward insurance companies and medicare saving money. Often when elderly are prescribed bone density meds, elderly its do not follow through regularly due to esophagititis, memory problems or other factors. We need to be alerted to poor bone density factors and numbers as a way of addressing non compliance and or the need for further follow up particularly to physics;l therapists. The practitioner needs to stay involved and often doesn't when testing does not continue. We need to promote a lll sorts of physical interventions, as falls are extremely expensive for hospitals and insurance….Too and they do not understand true prevention

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