Bone density checks for older folks

[Dominique]

@Audemars recently mentioned the importance of bone density for older folks, in the Do you have to run to be fit? discussion. I’m not particularly into running myself, but one of the reasons I run on a regular basis is precisely bone density: merely walking simply doesn’t pound your bones sufficiently for that, at least if you’re not very heavy. I also engage in resistance training as he suggests, for the same reason (although it’s not my main motivation for doing so).

My question is: when should you start to have the density of your bones checked, and how often should you do it? I’m 56 and I’ve never done it. I have no issue whatsoever with knees, hips or other bones for the time being, I’ve always eaten plenty of dairy products and other good stuff for keeping my body functional, but I know bone density is one of the things that change as we age, hence my concern.

[USAF-Larry]

Good discussion, @Dominique.  I'm not sure there are any hard an fast rules for beginning the screening, but I was pushed into it by the neurosurgeon that did my spine surgery. During the 7-hour surgery he noted that the bone in my spine was "very soft" and said that I needed to get a DXA test to determine the steps to correct it. Once I was mobile, they did the DXA test and it showed beginning Osteopenia and I was put on Calcium, Magnesium & Vitamin D supplements, and was advised to get another DXA in 2 years.  Prior to that, I had no indication that I had weak bones, and assumed with having been very physically active & fit my entire life that my bones would be very sound.  But, the doctor told me some things are hereditary and we can't do anything about it, plus the fact that I am well past 70....

In the brochure that was given to me, published by the U.S. National Osteoporosis Foundation, they recommend the following guidelines for beginning bone density scans:

• you are a woman age 65 or older.
• you are a man age 70 or older.
• you break a bone after age 50.
• you are a woman of menopausal age with risk factors.
• you are a postmenopausal woman under age 65 with risk factors.
• you are a man age 50-69 with risk factors.

[MarciM]

Thank you @USAF-Larry & @Dominique for sharing this information. I had never considered having a bone density check, but see the info below I need to add it to my list. Appreciate the thoughtful post, just one more reason I love this community and all the support and valuable information. 

[Dominique]

@MarciM: my understanding is it’s even more important for women. There was a special campaign ("Strong Bones") earlier this year in honor of Finland’s 100 anniversary to let women have a free screening.  

[SunsetRunner]

I had one pre-menopause and one post menopause.  Pre I had the bone density of a 25 year old (I was 43) and post, I was okay, but not in the 25 y/o range anymore so I lost a fair amount of bone-which is to be expected.  I haven't had the test since- but I exercise adequately and eat a lot of dairy (vitamin d) so I'm hopeful I'm maintaining.  I'd have to have full blown osteoporosis before I'd take any of the drugs that treat it and I don't think that will happen.

[WavyDavey]

I wonder how those scales that advertise measuring bone mass would stack up against DXA-- in terms of accuracy to price.

[USAF-Larry]

Having been through a DEXA, @WavyDavey, I would guess there could be no comparison of the accuracy of the consumer scales vs the dedicated DEXA X-ray machine for determining the bone mineral density.

"During a DEXA scan, X-rays are passed through your body. Some radiation is absorbed by the bone and soft tissue and some travels through your body. Special detectors in the DEXA scanner measure how much radiation passes through your bones, and this information is sent to a computer."

[emili]

I remember a million years ago my grandmom who is off the boat European (as am I) had turned 70 and was complaining that she shrunk half her size overnight. Of course it was said in jest, but I think there was some truth to it (not the overnight part). I think for women even more so than men this is really important. We tend to have more calcium deficiencies than men do which is a great contributor to bone issues. It's also one of those things we don't really think about as part of routine conversation at check ups. This is really good for awareness.. thanks @Dominique for bringing it up.

[Dominique]

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@WavyDavey wrote:

I wonder how those scales that advertise measuring bone mass would stack up against DXA-- in terms of accuracy to price.

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One of my three smartscales (!!!) – Withings (now Nokia) Body Cardio – happens to support bone mass. It’s just one number, total bone mass as estimated by the scale. I’ve had the scale since the beginning of the year (8 months) and bone mass has been the same (2.7 kg) every single day until last week: since then, it’s now 2.6 kg. During the time, my total bodyweight has steadily dropped from about 67 to 60 kg. I don’t really see what use I could have for that number (certainly doesn’t tell me much about actual density). So I agree with @USAF-Larry: a BIA scale - no matter how smart and fancy - wouldn’t compete with a proper DXA scan.  

[SunsetRunner]

For women, it's menopause and the reduction/disappearance of estrogen that precipitates bone loss  It's why it is so important to eat healthy and exercise when young-we need to start out with outstanding bones premenopause to have good bones after.  And for 'after' it is important to do weight bearing and strength exercises.

[WendyB]

I'm a firm believer in women getting this in. Its very important.

I thought I was and was wrong. I have had many problems.  Please make sure to get it in.

I get it checked every 2 years just to make sure I'm on the right track

[SunsetRunner]

According to the well-researched book "The First 20 Minutes", the only truly effective way to increase bone density is high intensity strength training. Aerobic exercise, including running, have next to no effect, and no increased intake of calcium and no medicine will give you anywhere near the same results as strength training. That said, of course you do need to ensure you don't have a calcium deficit. Also, if you stop strength training, your bone density will start to return to pre-training levels after only about 2 weeks, regardless of calcium intake, so it's really important to keep it up. Body composition analysers (the pro ones in gyms) usually also measure the weight of your bones which can give you an indication of your bone density.

[USAF-Larry]

@SunsetRunner, I don't know that it is a well-researched book, since I don't remember seeing any footnotes or citations of documented research, but that doesn't really matter to me.  But, none of the Orthopedic Surgeons nor Neurosurgeons that I have had have ever said anything other than any/all weight-bearing exercises, regardless of whether high-impact or low-impact, help increase bone density.  Some of the low-impact weight-bearing exercises include:

• Using elliptical training machines
• Doing low-impact aerobics
• Using stair-step machines
• Fast walking on a treadmill or outside

[SunsetRunner]

What you are mentioning is also what I have heard for many years, but apparently research done within the last 5-10 years proves otherwise. I'll check the sources and get back to you. This is a really important subject and I do want to get it right.