BoneKEy Reports | BoneKEy Watch
BMD testing in older postmenopausal women: how often?
DOI:10.1038/bonekey.2012.71
To clarify the optimum interval between bone mineral density (BMD) testing in women over 65, this study analyzed data from 4957 women older than 67 who were shown to have no signs of osteoporosis at baseline and no history of fracture risk. Some of the women did, however, have osteopenia, which was either mild, moderate or advanced.
During the long period of follow up, it was shown that the time for 10% of women either to develop osteoporosis that required treatment, or to have a vertebral or hip fracture, was 16.8 years for women whose BMD remained normal. For women who were mildly osteopenic it was 17.3 years; for women moderately osteopenic, 4.7 years; and for those whose osteopenia was advanced osteopenia, 1.1 years. The authors conclude that these findings should guide clinicians on the BMD testing interval required in different groups of postmenopausal women.
Editor's comment: Unfortunately, these data are mired in the past paradigm of basing treatment decisions on BMD alone. Many women over the age of 65 with osteopenia have an absolute fracture risk that meets US criteria for treatment, so whether they 'transition' to osteoporosis is not the important clinical question. These data and recommendations do not address monitoring intervals in younger postmenopausal women in whom bone loss is faster and more variable.
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