Osteoporosis is one of the most devastating diseases in America, especially for older women. Affecting up to 24 million people in the U. S., it has lead to half the hip fractures suffered in the elderly, resulting in some $14 billion a year in hospital and nursing home costs. Hip fractures are important since up to 20 percent of those suffering from them die within a year.

Unfortunately, despite being treatable, many women do not take the necessary precautions to prevent this problem. Calcium supplementation and medications such as Alendronate (Fosamax), can help slow down preventable fractures. To determine who is at the greatest risk for osteoporosis, it would be helpful to develop a screening test, to better target those who may develop osteoporosis in the later years. It's now well established that low bone density before menopause can accurately predict who will develop osteoporosis.

Enter The DEXA Scan

Dual Energy X-ray Absorption is an imaging machine that can measure one's bone mineral content. It's currently the most accurate and comprehensive in determining human bone density. It's also quick, taking approximately two to four minutes. Radiation is minimal and much less than one would receive from a regular chest X-ray. Bone density is measured at central sites of bone loss such as the hip and lumbar spine. If the DEXA scan is repeated periodically it can also tell how fast you are losing bone mass and density. A score is printed and compared with the national standard for bone density compiled by the World Health Organizations. If your score is below the 2.5 standard deviations from the mean, you are diagnosed with osteoporosis.

Despite their utility, DEXA scans are not as widely available in every community. Less expensive and more accessible are single energy X-ray absorption tests (SXA), which detects bone density at a certain part of the body, such as a heel or forearm. Although not as accurate, it can be completed in an examination room and is less costly. Newer machines utilizing Quantitative Ultrasound Technology might prove to be more accurate and still inexpensive to patients.

Who Should Get The Bone Density Test?

Women who are in their perimenopausal years (soon before menopause) would most likely get the most benefit of the DEXA scan. Others who may wish to have the test include those with family history of osteoporosis or have a personal history of bone fractures. Women who smoke or drink heavily are also at risk for osteoporosis, as well as those taking steroid medications for long periods. The National Osteoporosis Foundation recommends women younger than 65 years, with one or more risk factors of osteoporosis, to have their bone density tested.

Taking The Next Step

After you have completed the bone density study, go over the results with your doctor to make sure it's interpreted correctly. If you are diagnosed, as at risk for developing osteoporosis, your doctor will go over proper diet and lifestyle changes, such as weight-bearing exercise, needed to combat this disease. Your physicians may recommend medications as another treatment option or initiate hormone replacement therapy.

There are usually no signs or symptoms of osteoporosis until you get that first fracture and by that time it may be too late. Most doctors feel osteoporosis is a preventable disease, if more are willing to "take the next step".

For more information, contact the National Osteoporosis Foundation (http://www.nof.org).