Should I get a bone density test?

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Q. I'm 65 years old and have never had any bone health issues. Should I get a bone density test?

A. Bone density testing is a specialized x-ray technique used to diagnose osteoporosis (thin bones), a condition that increases the lifetime risk of fracture by six times in men.

Current guidelines from the U.S. Preventive Services Task Force do not recommend routine bone density testing for men because studies have not conclusively shown that osteoporosis medications can prevent fractures in men. Men also have a lower fracture risk compared with women because they have a higher baseline bone mass and lose bone more slowly with age.

Yet some medical societies disagree and recommend testing for men older than age 70. In addition, men at risk for osteoporosis may benefit by having a bone density test so they can adjust their lifestyle habits to help maintain bone strength and improve other aspects of their health.

In addition to older age, risk factors for osteoporosis in men include excessive alcohol use (more than two standard drinks a day), smoking, low testosterone levels, and treatment with corticosteroids (prednisone).

Both bone density and personal risk factors should be considered in deciding if osteoporosis medication is needed. One tool to calculate your fracture risk is known as FRAX (www.shef.ac.uk/FRAX/index.aspx).

Speak with your doctor about whether you need a bone density test. But keep in mind that making lifestyle changes like quitting smoking, increasing exercise, and moderating alcohol intake can have broad benefits for your bones and the rest of your body. And some research has found that increasing dairy foods may help older men maintain their bone density.

— by William Kormos, M.D.
Editor in Chief, Harvard Men's Health Watch