From the Research
There is no specific age at which DEXA scans should be universally stopped, but generally, DEXA scans may be discontinued when the benefits of continued bone density monitoring no longer outweigh the risks, typically when life expectancy is less than 5 years or when findings would not change management decisions. The decision to discontinue DEXA scanning should be individualized based on several factors including life expectancy, overall health status, and treatment goals. For most patients with osteoporosis who are on treatment, follow-up DEXA scans are typically performed every 1-2 years initially and may be extended to every 2-5 years once bone density stabilizes 1.
Some key points to consider when deciding to stop DEXA scans include:
- Life expectancy: If life expectancy is less than 5 years, the benefits of continued bone density monitoring may not outweigh the risks.
- Overall health status: Patients with multiple comorbidities may not benefit from continued monitoring.
- Treatment goals: If treatment decisions are unlikely to change based on DEXA scan results, monitoring may not be necessary.
- Patient preferences: Shared decision-making between the healthcare provider and patient is essential in making this decision.
In very elderly patients (typically over 85 years) with multiple comorbidities, clinicians may decide to continue osteoporosis treatment without further monitoring if the patient has previously documented osteoporosis 2. This approach recognizes that the small radiation exposure and cost of continued testing may not provide meaningful clinical benefit when treatment decisions are unlikely to change based on results.
It's also important to note that DEXA scans are just one tool used to assess bone health, and other factors such as clinical risk factors and patient history should also be taken into account when making decisions about osteoporosis treatment and monitoring 3. Ultimately, the decision to stop DEXA scans should be made on a case-by-case basis, taking into account the individual patient's needs and circumstances.