Who Should Get a Bone Density Test and Why It Matters for Long-Term Health
As the global population ages, osteoporosis has become an increasingly common concern. This condition, characterized by weakened bones and a higher risk of fractures from minor falls or stress, significantly impacts quality of life. Early detection through bone density testing—commonly known as dual-energy X-ray absorptiometry (DEXA or DXA scan)—can help identify bone loss before it leads to serious complications like hip or spine fractures. Understanding who should undergo this screening is crucial for prevention and long-term wellness.
High-Risk Groups That Should Consider Bone Density Testing
Bone density testing isn't just for those already showing symptoms—it's a proactive tool for at-risk individuals. Identifying low bone mass early allows for timely interventions such as dietary changes, supplements, exercise programs, or medication, all of which can slow or even reverse bone deterioration.
1. Women Over 65 and Those Experiencing Menopause
Women are significantly more prone to osteoporosis due to hormonal changes during menopause, which accelerate bone loss. The drop in estrogen levels affects bone remodeling processes, making bones more fragile. For this reason, medical guidelines recommend that all women aged 65 and older receive annual bone density screenings. Additionally, any woman going through perimenopause or early postmenopause—with irregular periods, hot flashes, or night sweats—should discuss bone health with their healthcare provider and consider early testing, especially if other risk factors are present.
2. Men Aged 70 and Above
While men typically have higher peak bone mass than women, they are not immune to osteoporosis. After age 70, bone density naturally declines in men, increasing fracture risk. Unfortunately, osteoporosis in men is often underdiagnosed because it's mistakenly seen as a "woman's disease." Regular bone scans starting at age 70 can detect silent bone loss and prevent debilitating fractures, particularly in the hip or spine.
3. Individuals with Elevated Risk Based on Lifestyle or Medical History
The International Osteoporosis Foundation promotes a quick self-assessment tool called the One-Minute Osteoporosis Risk Test, which includes ten simple questions about personal and family history. If you answer "yes" to any one of them—such as having a parent with a hip fracture, taking certain medications (like corticosteroids), or suffering from chronic inflammation—you should schedule a DEXA scan. This brief questionnaire helps identify high-risk individuals who may benefit from early intervention.
4. Anyone Who Has Experienced a Fracture After Age 50
A broken bone after midlife, especially from a minor fall (like stepping off a curb), could be a red flag for underlying osteoporosis. Hip, wrist, or vertebral fractures in adults over 50 warrant immediate bone density evaluation. These so-called "fragility fractures" often indicate significant bone weakening and increase the likelihood of future breaks. Early diagnosis following a fracture can dramatically reduce the risk of additional injuries.
5. Underweight or Malnourished Individuals
People with a body mass index (BMI) below 19 are at greater risk for low bone density. Being underweight means less mechanical stress on bones, which can lead to reduced bone formation over time. Additionally, insufficient intake of key nutrients like calcium, vitamin D, and protein further compromises skeletal strength. A DEXA scan can assess whether thinness is affecting bone integrity, allowing for targeted nutritional and lifestyle support.
6. Chronic Digestive Disorders, Especially Those Causing Malabsorption
Conditions like celiac disease, inflammatory bowel disease (IBD), or persistent diarrhea interfere with the body's ability to absorb essential bone-building nutrients. Even if someone eats a healthy diet, poor absorption can result in progressive bone loss. If you've been dealing with long-term gastrointestinal issues, a bone density test is strongly recommended to monitor skeletal health and guide treatment decisions.
7. Heavy Alcohol Use and Smoking Habits
Regular excessive alcohol consumption—defined as more than three drinks per day—has toxic effects on bone-forming cells and disrupts hormone balance. Similarly, smoking more than 20 cigarettes daily damages bone structure and reduces blood supply to bones. Both habits accelerate aging-related bone loss. Anyone engaging in these behaviors should undergo yearly bone density checks, alongside efforts to quit or reduce usage.
8. Men with Hormonal Imbalances or Sexual Dysfunction
Low testosterone levels in older men are closely linked to decreased bone mineral density. Symptoms such as fatigue, reduced muscle mass, low libido, or erectile dysfunction may signal hormonal deficiencies that also affect bone health. Testing bone density in men with these concerns can uncover hidden risks and prompt appropriate hormone evaluation and therapy.
Prevention Is Key: How Bone Density Testing Improves Quality of Life
Early detection of osteopenia (low bone mass) or osteoporosis enables meaningful action before a fracture occurs. With proper management—including weight-bearing exercise, adequate calcium and vitamin D, fall prevention strategies, and when necessary, prescription medications—patients can maintain independence and mobility well into later years. Bone density testing isn't just diagnostic; it's a vital part of proactive aging.
Ultimately, knowing your bone health status empowers you to make informed choices. Whether you're in a high-risk group or simply approaching older age, discussing a DEXA scan with your doctor could be one of the most impactful steps you take toward lifelong skeletal wellness.