Preventative Medicine

Question 1

Osteoporosis
What age should women be screened for osteoporosis?
What do the results indicate?
How should treatment begin?

Answer 1

• Age >65 screen all women with DEXA scan
• Begin at age 60 if low body weight or increased fracture risk
• Tests spine, hip and forearm
• T-score is bone density compared with control
• T-score is number of units (standard deviations) that bone density is above or below the average
• T-score > 2.5 SD indicates likelihood of osteoporosis and increased risk of fracture
• Z-score is number of standard deviations above or below what is normally expected for someone of the same age, sex, weight and ethnic or racial origin.
• Z-score < -2 may suggest that something other than aging is causing osteoporosis (such as corticosteroids)
• Treatment should be initiated with bisphosphonates, daily calcium supplementation and vitamin D