If you’ve read the recent recommendations from the January 22 edition of Life and Style from HealthyRockford.com, or the article in the New York Times, they tell us that we don’t need to have bone density testing as often as some of us have been doing. But before you decide to hold off on your next scan we need to look at what the study article, from the New England Journal of Medicine, actually said.
Firstly, the recommendation said that if you are 65 and have normal bone density, you could wait up to 15 years to repeat it again. Actually I agree with this statement, and if you are 65 and have normal bone that’s fantastic; 15 years is a bit long, but if that’s what they think - okay. This does make sense, since these people don’t need to treat anything, just monitor their scores. The problem is most of us don’t have normal bone density and may be 65 or under, so this doesn’t apply to us or anyone with osteoporosis or osteopenia.
We know that many aren’t accessing bone density tests anyway, and it’s a very underutilized test in some populations. So for these patients we have no idea what their bone looks like and a baseline test is the only way you’ll find out. If the insurance companies decide to follow this advice, that should not affect most of us. However, it could affect those getting their first scan, so we’ll have to wait and see if that happens If you are under or over 65 with bone loss you aren’t in this group they say can wait for the next test.
According to the National Osteoporosis Foundation, via Bonnie M. Johnson a nurse specialist and member of the NOF says_: Paraphrasing the National Bone Health Alliance’s (www.nbha.org) response which was sent to The New York Times and the Bloomberg News: "the findings should not be misinterpreted for those already diagnosed with osteoporosis or low bone density who should have bone density tests every two years to monitor their condition. _
These studies usually follow an assumption that a test is being overused, but according to the NOF, 13 percent of women who are Medicare eligible don’t have these tests done, so it would be a crime if we cut patients off from this service.
We also need to remember that women lose 20% of their bone following menopause, so they need to be screened to find out where they stand with the possibility of having osteoporosis or osteopenia. The NOF recommends testing for postmenopausal women 50-69 with risk factors and adults who have a fracture after the age of 50. They also recommend women over 65 and men at 70 to have a screening test.
This test is the gold standard for determining bone loss, so let’s not discard it now. The test is simple and can include a FRAX score, which will give you an idea of your risk for fracture in the future.
We are told that osteoporosis is treatable and can be prevented, so these DXA tests are the only way we can truly find out if we need treatment earlier in life than we might have thought. So we don’t want to hamper our ability to treat, prevent and maintain good bone health now.
- National Bone Health Alliance http://www.nbha.org/ retrieved January 27, 2012
- Bone density tests important in osteoporosis fight, January 26, 2012: by Bonnie M. Johnson at rrstar.com http://www.rrstar.com/opinions/whatyouresaying/x675926234/Guest-Column-Bone-density-tests-important-in-osteoporosis-fight