What is the recommended frequency of Dual-Energy X-ray Absorptiometry (DXA) scans in elderly women?

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Last updated: April 15, 2025View editorial policy

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From the Guidelines

DXA scans are recommended to be performed every 1-5 years in elderly women, depending on clinical circumstances, with the frequency influenced by the patient's clinical state, national clinical guidelines, cost, and reimbursement. When considering the management of osteoporosis in elderly women, it is crucial to weigh the benefits of frequent DXA scans against the potential risks and costs, including radiation exposure and financial burden 1. The decision on how often to perform DXA scans should be individualized, taking into account factors such as the patient's bone density, risk factors for osteoporosis, and response to treatment 1. Some key points to consider include:

  • DXA BMD measurement should be performed at the lumbar spine, total hip, femoral neck, and, if indicated, one-third radius 1.
  • Consider 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 1.
  • The frequency of BMD testing in clinical practice may be influenced by the patient’s clinical state, national clinical guidelines, cost, and reimbursement, with suggested intervals between BMD testing typically ranging from 1-5 years after starting or changing therapy 1. Given the most recent evidence from the European Journal of Nuclear Medicine and Molecular Imaging 1, the recommended frequency of DXA scans in elderly women should be based on individual clinical circumstances, with a general range of 1-5 years between scans.

From the Research

DXA Scan Recommendations for Elderly Women

  • The frequency of DXA scans in elderly women is not explicitly stated in the provided studies, but the indications for DXA scans are discussed in several studies 2, 3.
  • According to the 2013 Official Positions, DXA is the method of choice to assess fracture risk for women 65 years and older 2.
  • The study published in the Cleveland Clinic journal of medicine suggests that DXA is indicated in postmenopausal women with a high risk for fracture, but does not specify the frequency of scans 3.
  • There is no clear recommendation on how often DXA scans should be performed in elderly women, but it is implied that scans should be performed as needed to assess fracture risk and monitor treatment efficacy.

Factors Influencing DXA Scan Frequency

  • The presence of clinical risk factors, such as low body weight, prior fracture, high-risk medication use, or a disease or condition associated with bone loss, may influence the frequency of DXA scans 2.
  • The use of bisphosphonates and other osteoporosis medications may also impact the frequency of DXA scans, as these medications can affect bone mineral density and fracture risk 4, 5, 6.
  • The decision to perform a DXA scan should be based on individual patient factors and clinical judgment, rather than a specific recommended frequency.

Related Studies

  • Studies have investigated the use of DXA scans in postmenopausal women, including the 2013 Official Positions 2 and a study published in the Cleveland Clinic journal of medicine 3.
  • Other studies have examined the treatment of osteoporosis in postmenopausal women, including the use of bisphosphonates and other medications 4, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Indications of DXA in women younger than 65 yr and men younger than 70 yr: the 2013 Official Positions.

Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry, 2013

Research

To scan or not to scan? DXA in postmenopausal women.

Cleveland Clinic journal of medicine, 2020

Research

Treatment of osteoporosis after alendronate or risedronate.

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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