Saturday, September 20, 2008

Osteoporosis, osteopenia screening and prevention are best done when we're older

Most healthy women can wait until they are 65 to be checked for bone loss instead of 50. Drug therapy, its long-term effects unknown, can also wait. Studies have shown that most women will lose no more than 7% of their bone mass within the decade after menopause. Bisphosphonates have been shown to replace about 8% of bone within five years, so waiting will cost most women nothing. Counter to just about every other preventive healthcare message out there, when it comes to osteoporosis drugs, it's probably better to hold off. "Wait until the risk gets high enough," says Dr. Bruce Ettinger, adjunct clinical investigator at Kaiser Permanente, Northern California.

Even the drug marketers seem to be getting more realistic. "If you look at the TV ads, it's no longer the 45- or 50-year-old who's just finished her workout," says Ettinger. "It's a 65-year-old doing some stretching or gardening."

The current recommendation is that most healthy women get checked for bone loss with a bone-density test at age 65, not the minute they hit menopause, according to the U.S. Preventive Services Task Force. Those with risk factors, such as a family history of the disease, a fracture of their own, smoking, heavy alcohol use or a history of taking corticosteroids, should get a bone-density test around age 60, the 2002 recommendation said. And men should be tested at 70.