Women ages 65 and older should be screened at least once for osteoporosis, and so should postmenopausal women younger than 65 who are at high risk for the disease, according to new screening guidelines announced Jan. 17 by the U.S. Preventive Services Task Force.
Risk of developing the disease increases with age, said Dr. Ned Calonge, chairman of the task force and president of the health care group Colorado Trust.
“If your bones look like a 65-year-old's, or you have the same fracture risk as someone who's 65, then you should be screened for osteoporosis,” Calonge told MyHealthNewsDaily.
Previous recommendations, established in 2002, also said all women 65 and older should be screened, but beyond that only encouraged women 60 to 64 at high risk of the disease to be screened. To justify expanding the recommendations, the task force looked at a dozen additional studies published since 2002.
Explaining the recommendations
Osteoporosis affects women more than men, and women are twice as likely as men to break a bone due to osteoporosis, according to the Mayo Clinic.
The task force didn't issue guidelines for men because there weren't enough studies in men to justify a recommendation, Calonge said. However, the National Osteoporosis Foundation recommends all men 70 and older be screened at least once for osteoporosis, and all men older than 50 who are at high risk for the disease to be screened once.
And there aren't enough studies to recommend that women of normal risk for osteoporosis be screened more than once, Calonge said.
Osteoporosis screenings don't need to be done as often as other screening tests, such as mammograms, because loss of bone density occurs at a much slower rate than development of cancer, he said.
Controllable risk factors for osteoporosis include having a low calcium intake, smoking, leading a sedentary lifestyle, drinking more than moderate amounts of alcohol and taking certain medications. Uncontrollable risk factors include being a woman, getting older, being of white or Asian descent, having a chronic condition or having a family history of the disease, according to the Mayo Clinic.
Screening for osteoporosis helps identify people who are at an increased risk of developing the disease so they can take medications to stop the loss of bone mass and prevent future broken bones. Once you have osteoporosis, it's difficult to build new bone mass, Calonge said.
Research for menopausal women needed
Dr. Robert Recker, president of the National Osteoporosis Foundation, said the new screening recommendations were vital to identifying more people at risk. But he said he wishes there was more research done to justify a screening recommendation for women as they go through menopause.
Starting the year a woman reaches menopause and for about four years thereafter, her “T score” drops — bone density is measured by T scores, and a decrease means a loss in bone density. More studies need to be done to justify screening for women as their T scores drop during this time, Recker said.
“No one addresses the women who are actually going through menopause,” Recker told MyHealthNewsDaily. “We want to prevent them from getting to be at an even higher risk” of osteoporosis than they were to begin with.
If a person's bones are already losing their density, medications are the best way to stop the loss of bone mass. But earlier in life, people can do things to prevent the development of osteoporosis, he said.
Adults and adolescents should get at least 1,200 milligrams of calcium every day, and 1,000 to 2,000 units of vitamin D a day, Recker said. Physical fitness can also ward off decreases in bone mass.
Pass it on: Women ages 65 and older should get screened once for osteoporosis. Women younger than 65 who have a high risk of the disease should also be screened.
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