Osteoporosis screening interval should vary with BMD status
MedWire News: Baseline bone mineral density (BMD) should be used to set the interval between osteoporosis screening tests in older women, US researchers recommend in The New England Journal of Medicine.
"If a woman's bone density at age 67 is very good, then she doesn't need to be re-screened in 2 years or 3 years, because we're not likely to see much change," said lead author Margaret Gourlay (University of North Caroline, Chapel Hill, USA) in a press release.
"Our study found it would take about 15 years for 10% of women in the highest bone density ranges to develop osteoporosis."
Although BMD screening at regular intervals is recommended for women aged over 65 years, the optimum interval between tests has not yet been defined.
To investigate further, the team recruited 4957 women aged 67 years or older with no history of hip or vertebral fracture or treatment for osteoporosis. At baseline, 1255 patients had a normal BMD (total hip and femoral neck T score of -1.00 or above), and 4215 patients were diagnosed with osteopenia (T score, -1.01 to -2.49).
The researchers followed-up the patients for up to 15 years, and examined for the optimal BMD screening interval, defined as the estimated time for 10% of women to develop osteoporosis before sustaining a hip or clinical vertebral fracture, after adjusting for estrogen use and clinical risk factors.
The estimated BMD was 16.8 years for women with a normal BMD and 17.3 years for women with mild osteopenia at baseline (T score, -1.01 to -1.49).
However, the estimated interval fell to just 4.7 and 1.1 years for patients with moderate (T score, -1.50 to -1.99) and advanced (T score, -2.00 to -2.49) osteopenia, respectively.
"Our results suggest that osteoporosis would develop in less than 10% of older, postmenopausal women during screening intervals that are set at approximately 15 years for women with normal bone density or mild osteopenia… at the initial assessment, 5 years for women with moderate osteopenia…, and 1 year for women with advanced osteopenia," Gourlay et al conclude.
MedWire (http://www.medwire-news.md/) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012
By Lynda Williams