From the Guidelines
For a 69-year-old female patient with osteopenia (T-score of -1.7) who is not at increased fracture risk based on FRAX assessment, bone density screening should be repeated in 5 years. This recommendation is based on the most recent and highest quality study available, which suggests that repeating BMD testing at an interval of 4 to 8 years does not result in additional accuracy in predicting fractures 1. Given the patient's current T-score and lack of increased fracture risk, a 5-year interval is reasonable to monitor for significant changes in bone density while avoiding unnecessary testing. During this interval, the patient should maintain adequate calcium intake (1000-1200 mg daily), vitamin D (800-1000 IU daily), engage in weight-bearing exercise, avoid smoking, limit alcohol consumption, and take fall prevention measures to help stabilize bone density and reduce fracture risk while awaiting the next screening. It is also important to note that if the patient were to develop new risk factors such as starting corticosteroid therapy, experiencing a fracture, or developing a condition affecting bone health, earlier reassessment would be warranted. The studies from 2002 1 provide background information on the importance of bone density screening and the factors that influence the risk of osteoporosis, but the most recent study from 2025 1 provides the strongest evidence for the recommended screening interval.
From the Research
Bone Density Screening Interval
The appropriate interval for the next bone density screening in a 69-year-old female patient with a T-score of -1.7, indicating osteopenia, and not at increased risk of fracture, using the Fracture Risk Assessment (FRAX) tool, can be determined based on the following considerations:
- The patient's T-score is -1.7, which falls into the category of osteopenia, as defined by the World Health Organization 2.
- The Fracture Risk Assessment (FRAX) tool is used to evaluate the patient's risk of fracture, but the specific results of the FRAX assessment are not provided.
- Studies suggest that the screening interval for women with normal bone mineral density or mild osteopenia (T score -1.49 or higher) could be as long as 15 years 3.
- However, other studies recommend that the frequency of re-screening should be based on age and BMD T score, with more frequent testing for older age and lower T score 4.
- Given the patient's age and T-score, a reasonable approach would be to re-screen in 5 years, as this allows for monitoring of bone density changes over time while avoiding unnecessary frequent testing.
Screening Intervals
Some possible screening intervals to consider are:
- 2 years: This may be too frequent for a patient with a T-score of -1.7 and no increased risk of fracture.
- 3 years: This could be a reasonable option, but it may not be necessary to re-screen this frequently.
- 5 years: This is a more appropriate interval, as it allows for monitoring of bone density changes over time while avoiding unnecessary frequent testing.
- Other factors, such as the patient's clinical risk factors and overall health status, should also be taken into account when determining the screening interval 5, 6.