Bone Density

Bone density reflects the mineral content of bones — how strong they are. Peak bone density is reached by the late 20s; gradual loss starts in the 30s and accelerates in women after menopause and in men after 70. Low bone density is called osteopenia (mild) or osteoporosis (more significant), and raises the risk of fractures from minor falls. See the Osteoporosis page for the detailed treatment approach.

How bone density is measured

• DEXA scan (DXA) — the standard test. Low-dose X-ray of hip and spine; painless; takes 10-15 minutes.
• T-score compares to a young healthy adult: -1 to -2.5 = osteopenia; below -2.5 = osteoporosis.
• Z-score compares to peers of the same age — used in younger people.
• FRAX — a web calculator that estimates 10-year fracture risk, combining DEXA with age, history, smoking, alcohol.

Who should have a DEXA

• Women 65+, men 70+.
• Postmenopausal women under 65 with risk factors — low weight, smoking, family history, previous fracture.
• Men 50-69 with risk factors.
• Anyone with a fragility fracture (after minor fall or spontaneous vertebral collapse).
• Long-term steroid use, overactive thyroid, rheumatoid arthritis, coeliac disease, chronic liver/kidney disease, early menopause, absent periods in young women, certain cancer treatments.

What to do once you know the number

• Normal / mild low — lifestyle focus (calcium, vitamin D, exercise, quit smoking), repeat in 2-5 years.
• Osteoporosis — specific medicines (bisphosphonate-class, denosumab, teriparatide, etc.) plus lifestyle; repeat DEXA to monitor.
• Treat underlying conditions — thyroid, coeliac, vitamin D deficiency.
• Fall prevention — lighting, footwear, grab bars, vision, medicine review.

India-specific context

Despite sunny days, Indians are widely vitamin D deficient (covered clothing, indoor lifestyles, pollution, melanin). Dietary calcium is also often low. Both are highly fixable — supplements are inexpensive. DEXA scans are available in most Indian cities (₹1,500-₹3,000 typically); government and charitable hospitals often subsidise. Combined with cheap effective medication, osteoporotic fractures are largely preventable — yet many Indian adults discover the problem only after a broken hip.