Osteoporosis Screening: Factors Associated with Bone Mineral Density Testing of Older Women

Abstract

Consideration of factors associated with BMD testing may be useful in developing interventions to increase osteoporosis screening rates.

Obesity and fracture in men and women: An epidemiologic perspective

“…Considering the existing focus on the risk of underweight individuals for osteoporosis, it comes as no surprise that the rate of DXA screening declines as BMI increases. (69) This is likely to be due to a combination of provider and patient inattention to fracture as a legitimate health risk. The challenge is to devise fracture risk detection approaches that recognize the relatively lower risk of fractures in those with high BMI with the need to reduce the personal and population burden of their fractures.…”

“…(75) Comorbidities that are more frequent in obese people may also play a role in a lower frequency of screening. (69,73) While DXA screening is one area of focus, screening among overweight and obese populations for low and declining physical function, fall risk, and insufficiency of vitamin D and other nutrients may have even greater returns in improving not just bone health but also mobility and quality of life.…”

The World Health Organization Fracture Risk Assessment Tool (FRAX) Underestimates Incident and Recurrent Fractures in Consecutive Patients With Fragility Fractures

“…As such, our cohort differs from administrative cohorts based on BMD testing. Prevalence of BMD testing varies significantly across geographical areas, socioeconomic status, and age (27)(28)(29)(30). BMD-based cohorts often consist of younger and healthier individuals, thus underestimating FF rates in the general population.…”

Compliance with mammography and bone mineral density screening in women at least 50 years old

“…studies that also found low rates of BMD screening in at-risk women. 21,22 Given the high level of morbidity and mortality associated with osteoporotic fracture, it is unfortunate that compliance with screening recommendations is so low. This is especially true for women who have already experienced a fracture, because this is a readily identifiable risk factor and places these women at particularly high risk for a subsequent fracture.…”