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Monday, March 8, 2021

Women over 65: Get screened for osteoporosis

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Special to the Recorder

In an update to a recommendation that it made in 2002, the U.S. Preventive Services Task Force (USPSTF) is recommending that all women ages 65 and older be routinely screened for osteoporosis.

The USPSTF also recommends that younger women with increased risk factors for osteoporosis be screened if their fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors. White women are used as the benchmark because they have a markedly higher rate of osteoporosis and fractures than other ethnic groups. Risk factors for osteoporosis include tobacco use, alcohol use, low body mass and parental history of fractures.

Osteoporosis, a condition that occurs when bone tissue thins or develops small holes, can cause pain, broken bones and loss of body height. The screening for osteoporosis involves a measurement of bone density, which is currently covered by Medicare. The most commonly used bone density measurement tests are dual-energy x-ray absorptiometry (DXA) of the hip and lumbar spine, as well as quantitative ultrasound of the heel, although current diagnostic and treatment criteria are based on DXA tests alone. The USPSTF noted that there is a lack of evidence about how often screening should be repeated in women whose first test is negative.

The U.S. Preventive Services Task Force did not indicate a specific age limit at which screening should no longer be offered because the risk for fractures continues to increase with age and the evidence indicates that benefits can be realized within 18- to-24 months after starting treatment.  

In postmenopausal women who had no prior fractures caused by osteoporosis, the Preventive Services Task Force found evidence that drug therapies (including bisphosphonates, parathyroid hormone, raloxifene and estrogen) reduce the risk for osteoporosis-related fractures.  

Osteoporosis is more common in women than men and is more common in whites than any other racial group. For all demographic groups, the rates of osteoporosis rise with increasing age.

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