Five things to know about bone density screenings

As people age, bone density tends to decrease, increasing the risk of fracturing a bone. A 50-year-old woman has a 50% chance of fracturing a bone while a 50-year-old man has a 20% chance. There are no symptoms of low bone density, which is insufficient minerals in the bones, until a fracture occurs.

Preventive bone density screenings measure the mineral content of your bones. If you are at an increased risk for a bone fracture, treatment can help you live stronger. Medications cut the risk by 25 to 65%. 

“Low bone density is associated with an increased risk of breaking a bone, particularly the dreaded hip fracture, which can have a major impact on quality of life,” said Susanne Trost, MD, an endocrinologist with M Health Fairview and an assistant professor with the University of Minnesota Medical School. “Fractures change how people live. Many cannot live independently. They might have chronic pain, or chronic disabilities. There’s also an increased risk of death after breaking a bone, particularly after hip fracture.”

Trost shares five things to know about osteoporosis and bone density screenings.

What is osteoporosis?

Bone in your body is constantly being replaced. But when bone loss outpaces the creation of new bone, your bones can become weak, brittle, and prone to fracture. The condition is called osteoporosis. People with osteoporosis could break a bone in what might be a minor stumble for someone with healthier bones. Without preventive screenings, many people won’t know they have weak bones until they break one.

Bone mineral density is the amount of minerals, like calcium, in the bones. Normal mineral density equals strong bones. As bone mineral density decreases, bones become brittle and more likely to fracture. Brittle bones are typically an issue in older adulthood, but healthy bones begin in childhood.

Who needs bone density screening?

Generally, women should get their first bone density screening 10 years after entering menopause and men should be screened starting at age 70. Based on your results and risk factors, your doctor might recommend repeat screenings every two to 10 years.

People at high risk for developing osteoporosis should receive bone density screening. Risk factors include:

Can you prevent osteoporosis?

The ideal time to build bone strength is between ages 15 and 25. After that bone build is relatively stable until women go through menopause. At that time bone starts to decline quickly at first followed by a slower decline due to lack of estrogen and aging. Bone density in men peaks around age 35 then declines slowly and gradually over time.

One way to decrease the risk for osteoporosis is to eat foods high in vitamins and minerals, so your body doesn’t need to take them from bones. Although a healthy lifestyle is just as important as people get older, often your body is not able to add new bone, and medical treatment might be needed.

“You want to make sure you’re getting enough calcium in your diet,” Trost said. “Try to get calcium from various dietary sources like dairy products, milk, cheese, and yogurt, but also greens like broccoli and kale, legumes, beans, lentils, nuts, seeds, and whole grains.”

Vitamin D also helps get calcium into bones, so your doctor might recommend a supplement. Exercise also helps prevent osteoporosis. 

“We need to exercise to keep those muscles strong because the muscles are also very important and prevent us from falling and breaking bones,” Trost said. “Diet and exercise lifestyle measures should be continued even as we start treatment or medication.”

How is bone density screened?

Bone density screening is measured with a dual-energy X-ray absorptiometry (DXA) scan. For the test, you will lie on an X-ray table. You can keep your clothes on; just try to wear comfortable clothing with minimal metal.

The technician will move you in a few different positions to get images of your bones. A DXA scan uses a small amount of radiation, about the same as a standard chest X-ray (0.01 millisevert units), which is less than you would be exposed to on a cross-country flight (.04 mSv).

The machine will scan your hips, lower spine, and sometimes the forearm. It usually takes about 30 minutes. The area with the lowest bone mineral density will determine your score. After the screening, you’ll get a report that indicates whether you have normal or low bone density.

How is low bone density treated?

If your score is borderline for low bone density, your healthcare provider might monitor your bone density with additional screenings and recommend lifestyle adjustments to help maintain your bone strength. That could include eating more calcium-rich foods, taking a vitamin D supplement, and exercise.

Weight-bearing exercise, activities done from your feet, so things like walking, dancing, and playing pickleball, help build bone density. Weight training and balance exercise also help keep you stable. Exercise like swimming that works different muscle groups is important for staying strong. Exercise helps keep you from becoming fragile and helps prevent falls.

For more severe bone density loss, medications are available to improve bone density. All medications have been tested for fracture loss and have shown a 30 to 70% decrease in fractures. They can be taken as tablets, injection, or infusion.

Schedule a bone density screening

Talk to your doctor about what care is right for you. You can also learn more about bone density screenings or schedule an appointment.