Repeat measurement 8 years after a baseline measurement did not help in predicting fracture risk.
Guidelines recommend initial screening for osteoporosis at age 65, and in current practice, clinicians commonly repeat bone-mineral density (BMD) measurements every few years. In a prospective study of 4124 women aged 65 and older, researchers assessed the value of repeating BMD measurement 8 years after a baseline measurement for predicting fracture risk. Subjects were contacted by postcard every 4 months to determine whether they had experienced a hip or nonspine fracture; positive responses were adjudicated by reviewing radiology reports. Given that the study was designed to evaluate the value of repeat BMD measurements in predicting fracture risk, fractures that occurred before the second BMD evaluation were excluded from the analysis.
The mean T score of participants was –1.37 at baseline and –1.64 at repeat measurement. During a mean of 5 years after the second BMD measurement, new nontraumatic nonspine fractures were found in 877 women. The baseline BMD measurement and the repeat measurement predicted fracture risk equally well. Change in BMD between measurements also predicted fracture risk, but it was a weaker predictor than the baseline BMD measurement.
Comment: This prospective study failed to show that repeat BMD measurement, 8 years after a baseline measurement, has value for predicting incident fracture risk. However, the study did not address the value of repeating BMD measurement in managing osteoporosis treatment.
— Jamaluddin Moloo, MD, MPH
Published in Journal Watch General Medicine February 15, 2007
Hillier TA et al. Evaluating the value of repeat bone mineral density measurement and prediction of fractures in older women: The study of osteoporotic fractures. Arch Intern Med 2007 Jan 22; 167:155-60.