From the Guidelines
The recommended age for DEXA scan screening is 65 years for women and 70 years for men with no risk factors, but screening should start earlier for individuals with risk factors, as stated in the most recent guideline from 2025 1. When considering the age for DEXA scan screening, it's essential to take into account the individual's risk factors, such as low body weight, family history of osteoporosis, previous fractures, smoking, excessive alcohol consumption, certain medications, or specific medical conditions.
- The American College of Physicians recommends that clinicians periodically perform individualized assessment of risk factors for osteoporosis in older men, as stated in their 2008 guideline 1.
- However, the most recent guideline from 2025 1 provides updated recommendations, including considering DXA in all women at the age ≥ 65 years, men age > 70 years, and women and men age ≥ 50 years with risk factors for osteoporosis.
- Factors that increase the risk for osteoporosis in men include age (>70 years), low body weight, weight loss, physical inactivity, corticosteroid use, androgen deprivation therapy, and previous fragility fracture, as mentioned in the 2008 guidelines 1.
- The 2025 guideline 1 also recommends evaluating for prevalent vertebral fractures with VFA or standard radiography in patients ≥ 50 years with specific risk factors, or with a T-score < -1.0 in older men and women, historical height loss > 4 cm, self-reported but undocumented vertebral fracture, or long-term glucocorticoid therapy.
- Follow-up DXA scans are usually recommended every 1-5 years, depending on clinical circumstances, as stated in the 2025 guideline 1.
From the Research
DXA Scan Screening Age
- The recommended age for DXA scan screening is 65 years and older for women and 70 years and older for men, as stated in the 2013 Official Positions of the International Society for Clinical Densitometry 2.
- However, for postmenopausal women younger than 65 years and men 50-69 years, DXA scan screening is recommended only in the presence of clinical risk factors for low bone mass, such as low body weight, prior fracture, high-risk medication use, or a disease or condition associated with bone loss 2.
- The National Osteoporosis Foundation (NOF) guidelines also recommend DXA scan screening in postmenopausal women younger than 65 years and men 50-69 years only in the presence of clinical risk factors 2.
- Other studies suggest that osteoporosis prevention and management should start earlier, with lifestyle changes, exercise, and intake of calcium and vitamin D, but do not provide specific recommendations for DXA scan screening age 3, 4.
- The use of bisphosphonates for the prevention and treatment of osteoporosis is also discussed in the literature, but the recommended age for DXA scan screening is not specified 5.
- A recent study highlights the importance of DEXA and other imaging modalities in assessing osteoporosis, but does not provide specific recommendations for DXA scan screening age 6.