Study: Osteoporosis Guidelines Not Effective for Women, Ages 50-64

Dorian Martin Health Guide
  • When should menopausal women be screened for osteoporosis?

    Many doctors follow the recommendations of the  United States Preventive Services Task Force (USPSTF) which calls for all women who are 65 years of age and older to be tested for low bone mineral density. The guidelines also advise physicians to screen women who are between 50-64 years of age only if their probability of having a hip, vertebral, humerus or wrist fracture in the next decade is 8.3 percent or greater using the Fracture Risk Assessment Tool.

    However, a new study warns that the USPSTF recommendations actually may not be valid for these women who have more recently gone through menopause. This study involved 62,492 women between the ages of 50-64 years of age who were involved in the Women’s Health Initiative Observational Study and Clinical Trials. The average age of participants was 57.9. None of the study participants were taking medication for osteoporosis during the study.

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    The researchers’ analysis found that the USPSTF strategy only was able to identify slightly more than one-fourth of the total study participants who went on to have major osteoporotic fractures within a decade. The study also found that two other screening guidelines were only slightly more successful in predicting cases of osteoporosis. The Simple Calculated Osteoporosis Risk Estimate (SCORE) identified approximately 38 percent of the participants who eventually suffered fractures while the Osteoporosis Self-Assessment Tool (OST) predicted about 40 percent of the women who suffered future fractures.

    Scarily, these percentages changed drastically when researchers analyzed by participant age.  The USPSTF guidelines only identified 4.7 of study participants between the ages of 50-54 and 20.5 percent of the study participants between the ages of 55-59 who ended up developing a fracture within the decade. The SCORE model identified 18.5 percent of participants between the ages of 50-54 and 22.1 percent of participants between 55-59 who would suffer a broken bone due to osteoporosis within the 10-year period. The OST successfully predicted only 22.9 percent of the participants between the ages of 50-54 and 36.7 percent of those between the ages of 55-59 who suffered fractures over the 10-year period.

    “If we want to prevent fractures, we need tools that help us accurately predict who will suffer these osteoporotic injuries so that we can target these at-risk people for preventive measures,” said Dr. Carolyn Crandall, a professor of medicine at UCLA’s David Geffen School of Medicine who served as the study’s primary investigator. “Our results suggest that our current guidelines for screening in younger post-menopausal women do not accurate identify who will suffer a fracture.”

    Therefore, it’s really important as women as they go through the menopausal transition to focus on bone health and also talk to their doctor about bone screening. The National Osteoporosis Foundation recommends the following:

    • Consume enough calcium and vitamin D. Starting at the age of 51, the recommended daily allotment of calcium jumps to 1,200 milligrams daily from food and supplements. You also need to get between 800-1,000 IU of vitamin D daily from sunlight, food and supplements.
    • Eat a well-balanced diet that is rich in fruits and vegetables. Foods that are good for your bones include low-fat and non-fat dairy products, canned sardines and salmon, fatty fish (salmon, mackerel, tuna and sardines), dark leafy greens, okra, tomato products, broccoli, artichokes, plantains, potatoes, sweet potatoes, raisins, papaya, oranges, orange juice, bananas, prunes, red peppers, green peppers, grapefruits, strawberries, Brussels sprouts, papaya, pineapples, and calcium-fortified foods.
    • Get regular exercise. It’s especially important to do both weight-bearing exercises (such as running, dancing, hiking, walking, and low-impact aerobics) and muscle-strengthening exercises (such as lifting weights or using elastic exercise bands). In addition, non-impact exercises can help you with balance, posture and function, and thus, can help ensure you’re lowering your risk of falls and broken bones.
    • Avoid smoking.
    • Limit alcohol consumption since heavy drinking can lead to bone loss.
    • Limit consumption of caffeine, coffee, tea and colas, which also may interfere with bone health.

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    Crandall et al. (2014). Comparison of fracture risk prediction by the US Preventive Services Task Force Strategy and two alternative strategies in women 50-64 years old in the Women’s Health Initiative. The Journal of Clinical Endocrinology & Metabolism.

    National Osteoporosis Foundation. (ND). Prevention and healthy living.

    University of California, Los Angeles. (2014). Osteoporosis screening guidelines miss many post-menopausal women. Press release.

Published On: November 03, 2014