Study suggest most women can wait 15 years between bone density tests
According to the International Osteoporosis Foundation, osteoporosis is estimated to affect 200 million women worldwide. The cost to the United States health care system costs as much as $18 billion dollars each year.
Now a new study reports that bone loss and osteoporosis develop slowly in most women with normal bone tests at age 65 could wait fifteen years safely, before a second test is done.
According to Dr. Margaret Gourlay, M.D., MPH, University of North Carolina at Chapel Hill School of Medicine, professor in the department of family medicine at UNC and lead author of the study, noted that current recommendations relies on bone mineral density readings in order to predict the rate at which bones will weaken with time. Dr. Gourlay stated "This is the first U.S. study to do it based on patients."
According to this new study researchers are questioning whether frequent bone density measurements make any sense for large percent of older women whose bone density is not near the danger zone on initial tests which are recommended at age 65.
The study had followed almost 5,000 women aged 67 and older for more than ten years. Upon entering the study the women had a bone density test and no osteoporosis.
Researchers reported that less than one percent of women with normal bone density at the start of study and less than five percent with mildly low density had developed osteoporosis in the subsequent fifteen years. However, those with considerable low bone density at the start of study close to the end point for osteoporosis of less than 2.5 standard deviations from the reference level, 10% progressed to osteoporosis around one year.
According to Dr. Gourlay, “There’s strong belief that the more we test, the more we are helping patients.” “This is a good example of why that doesn’t hold up at all.” In a telephone interview she stated each screening costs around $250 and unnecessary tests leads to a false positive and prescription drugs leading to a greater risk for the patient than protection.
Medications such as Fosamax and Boniva belong to the class of drugs called bisphosphonates. However, medical experts do not want women to take these medications for an indefinite period of time and no longer consider the bone density test the only factor to determine if a women needs to be treated for osteoporosis. Dr. Ethel S. Siris, osteoporosis researcher at Columbia University and not part of the study had stated currently osteoporosis experts consider osteopenia to be a risk factor and not a disease.
Now most health experts recommend that most of those on bisphosphonates like Fosamax take them for just five years at a time, followed by what they refer to as a “drug holiday”. This is to reduce the risk of rare but serious side effects such as thighbone fractures.
Researchers recommend screening for all women who are 65 and older and women aged 50 to 64 if they smoke, consume alcohol daily, weigh less than 127 pounds, have rheumatoid arthritis, have already had a fracture which suggest their bones may be weak or who have had a parent who had endured a hip fracture.
Dr. Steven Cummings, M.D., FACP, principal investigator for study and emeritus professor of medical epidemiology and bio-statistics at the University of California, San Francisco, stated “Bone density testing has been oversold.”
This study appears in the New England Journal of Medicine.
Some ways to help prevent osteoporosis:
Get enough calcium through food such as dark green leafy vegetables and legumes.
Alcohol consumption for women should be limited to one glass daily such as 5 ounces of one, 12 ounces of beer, one and half ounces of spirits.
If you smoke try to quit. Smoking doubles the chances of bone loss and fractures.
Some studies have found that cola drinks could contribute to bone loss. This applies to cola and not other carbonated drinks.
Get thirty minutes of exercise each day. Some exercises that can keep your bones strong include: