underweight, drinks
more than two alco-
holic drinks a day,
has a family history
of osteoporosis, or
has previously bro-
ken a bone. But don’t
wait for your doctor to
order a scan. If you’ve
had one broken bone,
research shows that
your odds for another
increase as much
as ninefold. Yet in
a 2017 NOF survey,
96 percent of women
who’d had a fracture
said their doctors
still didn’t recom-
mend getting a bone-
density test.
“After a heart attack, people are
evaluated and put on a plan with
medication and lifestyle changes to
prevent another one. The same thing
should happen after a fracture,” says
Bart Clarke, MD, the president of the
American Society for Bone and Min-
eral Research and a researcher at the
Mayo Clinic College of Medicine and
Science.
A big part of the problem is that
the number of private physicians
with DXA scanners has dropped
26 percent since 2007, when Medicare
reduced the amount of money it pays
doctors per scan. Most hospitals still
offer scans, but in rural areas, this can
mean that patients have to drive hoursto get one. As a result,
since 2008, nearly
3.7 million fewer
women on Medi-
care have had bone-
density tests than
had been projected.
On the plus side,
in 2018, a coalition of
bone-health groups
recommended that
after a hip or spine
fracture, all health-
care practitioners in-
volved in a person’s
care—from ER doc-
tors and primary care
physicians to gyne-
cologists, orthopedic
surgeons, physical
therapists, and regis-
tered dietitians—make sure there’s a
bone check and, if needed, treatment.
That’s already happening at ap-
proximately 200 medical centers
around the United States, with good
results. Kaiser Permanente Southern
California’s Healthy Bones Program,
for example, cut second-fracture rates
by up to 60 percent in four years.
If you’re younger than 40 and have
risk factors for osteoporosis, it’s not
too early to talk with your doctor
about getting tested. Anyone 40 or
older, meanwhile, can estimate his or
her fracture risk with the online Frac-
ture Risk Assessment Tool (FRAX) at
sheffield.ac.uk/frax. FRAX doesn’t re-
place a bone scan, but it is a good way94 may 2019
Reader’s Digest
MEN
AGE 50+
are more likely to have
an osteoporosis-related
bone break than
prostate cancer.