Under what circumstance can DEXA screening be performed earlier than age 65?

• A. Can be done earlier based on risk of fracture
• B. Based on hair color
• C. Based on BMI only
• D. Based on age alone

Answer: (A)

DEXA screening timing hinges on fracture risk, not simply on age. In people with higher fracture risk, starting screening before 65 is appropriate to identify low bone density early and guide treatment. This includes factors like a prior fragility fracture, long-term glucocorticoid use, low body weight, smoking, alcohol use, or certain medical conditions that weaken bones.

That’s why the correct approach is to screen earlier based on fracture risk. Hair color has no relevance to bone health, BMI alone doesn’t determine eligibility (though very low BMI can be a risk factor), and age alone isn’t a sufficient reason to skip or require screening.