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.