Bone-Density Testing Interval and Transition to Osteoporosis in Older Women

This study analyzed the transition from normal BMD or osteopenia to osteoporosis; in women 67 years of age or older, the time for 10% to develop osteoporosis was approximately 15 years for normal BMD or mild osteopenia at baseline, 5 years for moderate osteopenia, and 1 year for advanced osteopenia. Current osteoporosis management guidelines 1 – 7 recommend routine bone mineral density (BMD) screening with the use of dual-energy x-ray absorptiometry (DXA) scans for women 65 years of age or older, but no guidelines specify an osteoporosis screening interval that is based on data from longitudinal cohort studies. The U.S. Preventive Services Task Force stated in 2011, “Because of limitations in the precision of testing, a minimum of 2 years may be needed to reliably measure a change in BMD; however, longer intervals may be necessary to improve fracture risk prediction.” 1 To our knowledge, no U.S. study has addressed this clinical uncertainty. . . .