From the Guidelines
Bone Density Decrease and Testing
Bone density typically starts to decrease in women after menopause, around age 50-55, and in men after age 70 [ 1 ].
- It's recommended to start monitoring bone density with a dual-energy X-ray absorptiometry (DXA) scan at age 65 for men and postmenopausal women, as suggested by the National Osteoporosis Foundation [ 1 ].
- However, if you have a family history of osteoporosis, are taking medications that affect bone density such as corticosteroids, or have other risk factors, your doctor may recommend starting earlier, around age 50-60.
Stopping Bone Density Tests
As for stopping bone density tests, it's generally recommended to continue monitoring every 2-5 years if you have osteoporosis or are at high risk of fracture.
- If your bone density is normal, your doctor may recommend stopping or reducing the frequency of tests after age 75-80, depending on your individual risk factors and health status.
- The American College of Physicians recommends that clinicians assess older men for osteoporosis risk factors and use DXA to screen men at increased risk who are candidates for drug therapy for osteoporosis [ 1 ].
From the Research
Bone Density Decrease
- Bone density typically starts to decrease at around 40 years of age, after a constant bone mass is maintained during the first two decades of life and until this point 2.
- In women, bone mass is rapidly reduced at menopause, which occurs at around 50 years of age 2, 3, 4.
- After menopause, bone mass slowly decreases in both men and women who have passed the 70-year-old mark 2.
Rate of Bone Density Decrease
- The rate of bone density decrease varies by site, with the forearm experiencing the most pronounced bone loss after menopause (1.2%/year) 5.
- In women, bone loss nearly triples in the early postmenopausal years (<10 years since menopause), and thereafter decreases to the premenopausal rate for the hip, and to zero for the lumbar spine 5.
- In men, there is a small longitudinal bone loss in the hip throughout life, and a small bone loss in the distal forearm after the age of 50 years 5.
Factors Influencing Bone Density
- Bone mass is influenced by many factors, such as nutrition, physical activity, smoking, and alcohol intake, as well as genetic factors 2.
- A healthy diet providing balanced nutrients, including calcium, vitamin D, vitamin K, and protein, regular physical activity, and not smoking help maintain bone health and delay or prevent osteoporosis 2.
- Age is by far the main determinant of hip fracture incidence, and for women of a given age, their age at menopause has, at most, a weak additional effect 4.