Article: Capacity for and Utilization of Dual-Energy X-Ray Absorptiometry Within the Veterans Health Administration
Authors: Heather Davila, Kimberly D McCoy, Michelle A Mengeling, Radhika R Narla, Melissa J A Steffen, Karla L Miller, Samantha L Solimeo
Journal: J Am Geriatr Soc. 2026 Mar;74(3):900-903.
Excerpt:
Approximately 50% of women and 25% of men aged ≥ 50 years have osteoporosis, a condition characterized by reduced bone mass and compromised bone architecture, leading to a higher risk of fractures [1]. Fractures among older adults are common and associated with significant morbidity and mortality [2]. By 2040, the number of fractures in the United States is expected to increase by 68% to reach 3.2 million annually, with costs over $95 billion [2]. This burden could be reduced with targeted screening and treatment.
Bone mineral density (BMD) is a crucial indicator of fracture risk; guidelines recommend screening those at high fracture risk using dual-energy x-ray absorptiometry (DXA) to measure BMD and diagnose osteoporosis. Despite its availability, DXA imaging remains underutilized for patients at risk for first fracture and those with prior fracture indicating high risk for recurrence. Hip fracture rates increased among male Veterans aged ≥ 50 years between 2006 and 2019, although fewer than 6% underwent DXA imaging within 2 years post-fracture. A recent clinical trial involving male Veterans aged 65 to 85 years found DXA rates of 3.2% in the control group.
The Veterans Health Administration (VHA) is the largest integrated healthcare system in the United States, providing healthcare to 9 million Veterans, with emphasis on primary care and preventive services. Our goal was to evaluate VHA’s internal capacity to meet the demand for DXA imaging among Veterans at high fracture risk.
Link to journal online: https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.70222