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Osteoporosis - a loss of bone density, or "thinning" of the bones - is increasingly common the older we get. It's particularly common among older women. Osteoporosis can boost risks of dangerous bone fractures, make movement painful and difficult, contribute to other health problems, and lessen quality of life.

The U.S. Preventive Services Task Force recommends that women 65 and older be screened for osteoporosis regularly. (Health care workers often use a "bone densitometry" test, which measures bone density, in screening.) And many experts agree that older adults who have been diagnosed with osteoporosis or have had a bone fracture should take medications, such as amino-bisphosphonate drugs, that can help stop or slow bone loss.

New Research in the Journal of the American Geriatrics Society

To determine whether giving routine bone density tests to older women - and treating those who have osteoporosis with an amino-bisphosphonate drug - is cost-effective, researchers did a complex computer analysis using statistical information from previous studies.

Screening and treatment programs, and other medical interventions, are considered "cost-effective" if they result in significant health and functional benefits to the patient at reasonable cost.

In their analysis, the researchers looked at both the costs and health consequences of screening and treating women ages 65 and older,and the costs and health consequences of not doing routine screening among older women.

For women getting routine screening and treatment, costs included the cost of bone densitometry and the amino-bisphosphonate drug. Health consequences included a reduced risk of suffering a bone fracture and pain and complications from such a fracture.

For those not getting routine screening and follow-up treatment, health consequences included an increased risk of bone fracture and related complications, such as a greater likelihood of needing long-term care in a nursing home, and diminished quality of life. Costs included the cost of medical treatment for fractures, and long- term care.

Routine screening and treatment, the researchers' analysis showed, was cost-effective for all women aged 65 and older.

"These results strongly suggest that more active screening for osteoporosis in older people, including nursing home residents, should be encouraged," they conclude.

What Should I Do?

Ask your doctor whether you should be screened for osteoporosis.

The U.S. Preventive Services Task Force recommends routine screening for women 65 and older, and for women between 60 and 65 who are at increased risk of fracture. A number of things can increase your risk, including: having close relatives with osteoporosis; being white or Asian; having small bones or weighing less than 127 pounds; smoking; drinking too much alcohol; getting too little calcium or weight-bearing exercise and taking certain medications. Ask your doctor about these risk factors.
Older men can also develop osteoporosis but later in life than women.

For more information on osteoporosis, visit http://www.healthinaging.org/agingintheknow/chapters_ch_trial.asp?ch=27.

The summary above is from the full report titled, "Universal Bone Densitometry Screening Combined with Alendronate Therapy for Those Diagnosed With Osteoporosis is Highly Cost-Effective for Elderly Women." It is in the October 2005 issue of the Journal of the American Geriatrics Society (Volume 53, Issue10). The report is authored by John T. Schousboe, MD, MS; Kristine E. Ensrud, M. MPH; John A. Nyman, PhD; L. Joseph Melton III, MMD, MPH and Robert L. Kane, MD.