One of the consequences of the aging process is the weakening of bones. It can result in conditions such as osteoporosis. The risk of bone fractures among people with this condition leads to the necessity of conducting a bone mineral density test. As osteoporosis has no evident symptoms, it is hard to say if a person is at risk of breaking bones due to their poor quality or not. The test allows predicting the possibility of bone fractures among different categories of patients with no early symptoms.
A bone mineral density test aims at any people with the existing risk of bone problems, but primarily women and older adults. It measures the amount of calcium and other minerals in a patient’s bones. The most common method to scan bones is a “dual-energy x-ray absorptiometry (DEXA) scan” (“Bone mineral density test,” 2020). The results are the values of T-score (comparison of one’s bones’ condition to that of a young woman without any health issues) and Z-score (comparison with other people of the same age, gender, etc.). Therefore, it allows the physicians to assess the risks for one’s bones in comparison with the bones of people under equal conditions.
Some categories of patients have a higher risk of problems with bones and the development of osteoporosis than others. According to Densmore et al. (2017), all the women aged 65 years and older should take the test as they are in the risk group (p.293). They should also repeat screening every 1-5 years since the first time they take it. The frequency varies according to the first scan results. Depending on these results, physicians might suggest treatment of osteoporosis or preventive measures if there is a risk of developing the condition.
The recommendations of specialists regarding the frequency of the bone mineral density tests remain uncertain. One can hardly assess the effectiveness of the physicians’ prescriptions, considering the long intervals between the tests and the difference in their recommendations. VanGompel et al. (2017) provide more precise guidelines for repeating the tests “within two years of initial screening,” and every 1-2 years in the process of treatment (p.1090). However, it is impossible to eliminate the human factor in the decision-making process, and these recommendations remain the exclusive responsibility of a physician.
The difference in specialists’ assessments of risk and non-compliance with the requirements for the second test lead to uncertainty in patients’ conditions. VanGompel et al. (2017) claim that only 60% of women with a higher risk of osteoporosis development and bone fracture took the second test within a period of five years since the first examination (p.1095). It is difficult, therefore, to observe the trend of osteoporosis development among the women of the risk group.
The facts set forth above also lead to the emergence of possible deviations from routine screening frequency. Risk groups include not only women aged 65 and older, but younger women and men of any age. Several factors can lead to the same conditions as the ones of older women. They include bone fracture at the age of 50, a family history of patients, and the history of treatment for cancer, diabetes, and other diseases. Early menopause, long-term use of some medicines, low body weight or mass index, loss of height, or excessive tobacco or alcohol use can also contribute to increased bone fracturing (“Bone mineral density test,” 2020). The combination of factors plays a more significant role than only gender and age.
The factors mentioned above, as well as a person’s lifestyle, contribute to the general state of health on a case-by-case basis. Therefore, a younger woman or a man can have a risk of osteoporosis development or bone fractures that equals to the one of an older white woman (VanGompel et al., 2017). It is one of the primary reasons for potential deviations from routine screening frequency, together with subjective physician’s orders.
Another factor that has an impact on the screening frequency is the prescription of osteoporosis drug after the initial test. Once a person receives the recommendation on some medicines, he or she automatically becomes the one who is more likely to take the following tests at regular intervals (VanGompel et al., 2017). This person might not necessarily be a woman aged 65 or older, as in this case, the prescription depends on the actual condition of a patient.
The bone mineral density test is an efficient tool to prevent bone fractures and identify the risk of osteoporosis development. The orders of physicians for their patients differ, and this situation leads to the lack of factual information on the recommended screening frequency and identification of the members of groups at risk. To increase the efficiency of bone mineral density tests and provide more detailed information on the number of people with fracturing bones, common rules for physicians should exist. There is a need for prescription of the bone scan to people of different gender, age, and race, not only older women at risk.
References
Bone mineral density test. (2020). Web.
Densmore, J. E., Turner, M. B., & Dutton, L. A. (2019). A Pocket Guide to Clinical Midwifery: The Efficient Midwife. Burlington, MA: Jones & Bartlett Learning, LLC.
VanGompel, E. C. W., Franks, P., Robbins, J. A., & Fenton, J. J. (2017). Incidence and predictors of repeat bone mineral densitometry: a longitudinal cohort study. Journal of general internal medicine, 32(10), 1090-1096.