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The Most Important Osteoporosis Question You’re Not Asking

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The National Osteoporosis Foundation recommends that all women receive bone density screenings beginning at age 65 and all men receive screenings at age 70. Younger adults receive bone density screenings if they have a high risk for osteoporosis or have already experienced a fragility fracture.

Bone density, reported as a T-score and measured by a DXA scan, becomes a central focus for patients with osteoporosis. Medications aim to increase bone density, and patients and doctors are thrilled to see the T-score increase.

But consider this: low bone density is a number on a test. It is not the most important thing to consider with osteoporosis. After all, having a low bone density test number won’t kill you. Breaking a bone is the most important risk with osteoporosis, because osteoporosis hip fractures do kill up to 40% of people who get them.

So the most important question to ask about any test or anything that’s being recommended to you is how well does it predict or reduce fracture risk. The answers might surprise you, but they also can put you on the road to making smart and informed decisions for your health.

How well, then, does a bone density scan predict fractures? It might surprise you to learn that a bone density scan predicts less than half of all people with osteoporosis who will get an osteoporosis fractures. One study concluded that a bone density test only predicted 44% of women and 21% of men who fracture.

While all the science and technical jargon around osteoporosis might seem overwhelming, just remember this one simple question and keep asking it about every test and every approach someone suggests to you.

Here are some examples:

  • How much does a bone density test predict fracture risk?
  • How much does a medication reduce fracture risk? A hip fracture can be deadly, so ask how much it reduces fracture risk at specific sites on the body, such as hip and spinal fractures.
  • Have clinical trials shown that the ingredients in an osteoporosis supplement reduced fractures?
  • Has research on a diet you’re being recommended conclude that eating a specific way reduces fractures?

Becoming a savvy healthcare consumer means knowing the right questions to ask. Fortunately, with osteoporosis, that question is simple. I think what you’ll find when you start asking it, however, will surprise you.

Read about the 6 Steps to Reduce Fracture Risk that you can do.

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References

Cosman F, de Beur SJ, LeBoff MS, et al. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014;25(10):2359-2381. [article]

Schuit SC, van der Klift M, Weel AE, et al. Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone. 2004;34(1):195-202. [article]

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