Bone Density Test - Who Should Have It and How Often?

Should You Have Periodic Bone Density Tests?

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A bone density test assesses the mineral content of your bone, an indicator of your bone's strength. Bone density is classified as normal, low (associated with a condition known as osteopenia), or significantly low (associated with having osteoporosis).

Osteoporosis is considered a silent disease because there are usually no symptoms until a fracture occurs. Essentially, knowing your bone density is akin to knowing your fracture risk.

That's why it's important to check bone density. Treatments are available, if needed, to improve bone density and subsequently lower fracture risk.

Who Should Be Tested?

Generally, bone density testing is recommended for women between ages 50 and 65 with risk factors for osteoporosis and for all women over the age of 65. Also, men and women taking certain medications (e.g., corticosteroids) or those with certain diseases (e.g., rheumatic diseases, including rheumatoid arthritis) have an increased risk of osteoporosis and may be referred for bone density testing by their doctor. The National Osteoporosis Foundation recommends getting a bone density test if you fit any of the following categories:

  • woman age 65 or older
  • man age 70 or older
  • broke a bone after age 50
  • woman of menopausal age with risk factors
  • postmenopausal woman under age 65 with risk factors
  • man age 50-69 with risk factors

A bone density test may be necessary if you have:

  • an x-ray of your spine showing a break or bone loss in your spine
  • back pain with a possible fracture in your spine  
  • height loss of half inch or more within one year
  • total height loss of 1.5 inches from your original height

How Frequently Should You Be Re-Tested?

Once you have had a bone density test and your baseline is established, the recommended frequency for re-testing has been questioned.

According to the National Institutes of Health, people with normal bone density on their initial (baseline) test "might safely wait 15 years before getting re-screened." That conclusion was drawn from results of a study, published in the January 19, 2012 edition of the New England Journal of Medicine, that involved about 5,000 women. It was determined that less than 1% of women who initially had normal bone density went on to develop osteoporosis during the course of the study. Just 5% of study participants with mild low bone density went on to develop osteoporosis. Therefore, researchers concluded that women with normal or mild low bone density at baseline could delay re-testing for 15 years.  

The gold standard test for bone density is called a DEXA scan. With DEXA scan results, the lower your score, the greater your fracture risk. A T-score between:

  • 1 and -1 is normal
  • -1 to -2.5 is indicative of mild bone loss
  • -2.5 and lower is indicative of osteoporosis

Researchers also determined from the study that 1 in 10 women with moderate osteopenia at the time of their baseline exam developed osteoporosis in 5 years.

Of women who had severe or advanced osteopenia at baseline, 10% developed osteoporosis within a year. Re-testing at one year intervals is likely indicated for that group of patients. 

Medicare pays for bone density testing every two years. Many doctors order the test with that frequency. But, researchers now say that a 2-year re-test interval may not be necessary for most patients.

The Bottom Line

Your doctor will consider your age, osteoporosis risk factors, diseases and conditions, and the medications which you take routinely, when recommending when you should have your initial bone density test and how often to re-test. Follow your doctors orders.


Having a Bone Density Test. National Osteoporosis Foundation.

How Often Should Women Have Bone Tests? National Institutes of Health. December 3, 2012.

Bone-Density Testing Interval and Transition to Osteoporosis in Older Women. Gourlay ML et al. New England Journal of Medicine. January 19, 2012.

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