Osteoporosis screening is a necessary measure that helps monitor patients’ bone health. Standard tests for bone mineral density (BMD) for postmenopausal women, such as a Dual-energy x-ray absorptiometry (DXA), offer some degree of reliability. It is only recommended for women after 65 years old, failing to account for younger patients’ concerns (Cauley, 2018). US Preventative Services Task Force offers different screening tools for patients between 50 and 65 years or younger. These include FRAX (Fracture Risk Assessment), SCORE (Simple Calculated Osteoporosis Risk Estimation), and OST (Osteoporosis Self-Assessment) tests (Cauley, 2018). The effectiveness of the FRAX tool is questioned by some scholars (Bansal et al., 2015). Nonetheless, its availability poses it as a complementary method to access BMD for younger patients.
Younger patients’ lack of access to DXA is not the only weakness of this test. Komar et al. (2019) argue that DXA’s benefits are limited due to the size of the machine, its technical requirements, and patients’ exposure to radiation. The authors suggest ultrasonography as an alternative for assessing BMD for both younger and older patients. According to Komar et al., the results of ultrasonography are compatible in quality with those of DXA. This test provides low-cost and effective care to patients from different age groups.
The variety of tools for osteoporosis screening shows that this problem has to be actively reviewed for patients younger than 65 years. As an advanced practice nurse, it is vital to suggest early alternative screenings if some signs are present in a patients’ health history. Moreover, some additional research performed by nurses in this sphere can help providers to increase the accuracy of tests and lower the threshold for screening’s start.
References
Bansal, S., Pecina, J. L., Merry, S. P., Kennel, K. A., Maxson, J., Quigg, S., & Thacher, T. D. (2015). US Preventative Services Task Force FRAX threshold has a low sensitivity to detect osteoporosis in women ages 50–64 years. Osteoporosis International, 26(4), 1429-1433.
Cauley, J. A. (2018). Screening for Osteoporosis. JAMA, 319(24), 2483-2485.
Komar, C., Ahmed, M., Chen, A., Richwine, H., Zia, N., Nazar, A., & Bauer, L. (2019). Advancing methods of assessing bone quality to expand screening for osteoporosis. The Journal of the American Osteopathic Association, 119(3), 147-154.