A postmenopausal woman with a normal bone mineral density scan or mild osteopenia may require a repeat scan only after 15 years. However, the interval between testing should be more frequent in case of moderate to advanced osteopenia. These were the suggestions of a recent study.
Osteoporosis or thinning of the bone often affects postmenopausal women and predisposes them to fractures. The condition progresses from a milder condition called osteopenia to osteoporosis. Osteopenia could be further categorized as mild, moderate or advanced.
AdvertisementA Bone Mineral Density or DEXA scan is used to diagnose osteopenia or osteoporosis. The test results are given as a T score. A T score of above -1 is normal. A T score between -1 and -2.5 indicates osteopenia, and a T score of less than -2.5 indicates osteoporosis.
The US Preventative Task Force currently advises all women above the age of 65 years to undergo testing for osteoporosis. But it is currently unclear how often the test should be repeated.
A recent study conducted in the United States and published in the New England Journal of Medicine attempted to clear this aspect. In the study, 4957 women, 67 years of age or older were studied for a period of 15 years. These women had either normal bone mineral density or osteopenia at the start of the study. None of them suffered any fractures or underwent treatment for osteoporosis at the beginning of the study.
The bone mineral density testing interval in the study was defined as the estimated time during which 10% of the participants developed osteoporosis before they had a hip or clinical vertebral fracture or received treatment for osteoporosis.
The study found that women with normal bone mineral density or mild osteopenia (T score, −1.01 to −1.49) will take at least 15 years to suffer from osteoporosis, thus the test need not be repeated for at least 15 years in these cases. Women with moderate or advanced osteopenia, on the other hand, require more frequent testing. In case of moderate osteopenia (T score, −1.50 to −1.99), the testing should be done every 5 years and in case of severe or advanced osteopenia (T score, −2.00 to −2.49), it should be done annually.
The required time intervals between testing vary according to the age of the patient. Thus, the researchers suggest taking the age of the women into consideration while evaluating the intervals for screening for osteoporosis. The researchers also suggest considering other variables like decrease in activity or weight loss, which were not included in the study.
The recommendations of the study will definitely reduce health costs and avoid unnecessary frequent repeating of the test in postmenopausal women with normal bone mineral density.
1. Bone-Density Testing Interval and Transition to Osteoporosis in Older Women; Margaret Gourlay et al; N Engl J Med 2012; 366:225-233