Osteoporosis T Score

Understanding Osteoporosis T Score

Managing osteoporosis, whether for yourself or a loved one, requires understanding your T Score, a measurement used to assess bone density. Here, we are taking a closer look at what this is, how it is measured, what a low T Score indicates for an older person and what this might mean for health, treatment options for those with osteoporosis, and lifestyle changes that can support bone health.

At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For over 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about caring for older adults with osteoporosis, we can help.

What is osteoporosis?

Osteoporosis is a bone condition that is common in older adults, causing a loss of bone density. This can lead to bones becoming brittle and possibly more susceptible to fractures due to porosity and weakness that develops over time. Our bone density increases up until the age of 25, and stays at a healthy level from age 25 to 50. After age 50, bones start to become weaker, and this is particularly common in postmenopausal women.

Osteoporosis commonly affects bones like the spine, hips and wrists, and symptoms can include back pain, loss of height, a stooped posture, and more frequent fractures. Osteoporosis might also cause no symptoms, meaning it goes undetected until a fracture occurs due to a minor injury or a simple activity like coughing or sneezing.

If you have any of the signs of osteoporosis, it is important to speak to your doctor and get a diagnosis as soon as possible so you can gain a better understanding of your risks.

You can read more in our guide to the differences between osteoporosis and osteoarthritis.

What is an osteoporosis T Score and what does this indicate?

For those with osteoporosis, it is important to assess bone density in order to understand their bone strength and level of risk. This is measured using something called a ‘T Score’; a measurement used to assess bone density via a DEXA scan, which stands for dual-energy X-ray absorptiometry. The T Score is a way to compare an individual’s bone density to that of a healthy young adult, which indicates how strong or weak an older person’s bones are.

While other factors such as age, family history and medical conditions will also be taken into account, a DEXA scan offers a more in-depth look at bone strength which can provide more clarity on the level of risk for an older person, and what treatments or lifestyle changes should be considered.

How are T Scores measured?

You may need to have a DEXA scan if you are over 50 and at risk of osteoporosis, or under 50 with additional risk factors. For example, if you smoke or have previously broken bones. A DEXA scan is painless, quick and non-invasive, so it is accessible for any older person who may wish to know more about their bone heath. During the scan, an individual will have a safe level of radiation absorbed into their bones and soft tissue, allowing detectors within the DEXA scanner to measure how much radiation passes through the bones.

From there, the T Score will be measured, and this will be shown as a deviation measurement compared to what would be considered a normal bone density for a healthy individual. If this typical, healthy range is measured at zero, a bone density scan will indicate how close a person is to this score, or the scan may reveal a minus score. For example:

Above -1 standard deviation is considered a normal bone density
Between -1 and -2.5 standard deviation is in the range of osteopenia, which means a below average bone density, but not osteoporosis
Below -2.5 standard deviation is considered osteoporosis, which means bones are fragile and at risk of fracturing

What does a low T Score mean?

Depending on how low a person’s T Score turns out to be, they may have osteoporosis, which means their bones are particularly fragile. It is thought that, with every deviation below the norm, bone fracture risk doubles, meaning a person with a T Score of -1 may have twice the risk for a bone fracture if they fall or injure themselves. A person with a low T Score could also have a higher risk of complications after an injury, and may heal more slowly than other people.

Although a low T Score is cause for concern, it is certainly not a reason for you to be overly cautious to the point of losing your independence. Lifestyle, preventive measures, treatments and regular bone density testing to monitor changes can make a significant difference to your likelihood of fractures, so the long-term outlook of a low T Score doesn’t have to influence your level of activity going forward.

In fact, by knowing that you have a low T Score and therefore are more at risk, you can take steps to avoid significant injuries which can keep you healthier and mobile for longer. When this type of health information is known, it allows you to take preventive measures to avoid future fractures, and discover bone issues early in order to preserve your quality of life in the long run.

What treatment options are available based on T Score?

People with a low T Score usually have osteopenia or osteoporosis, and although there is no cure for these conditions, certain treatments can be offered by a doctor to slow bone density loss, such as:

Medications – Bisphosphonates like alendronic acid or ibandronic acid could be used, and these can come in tablet, liquid or injectable form. Other medications exist should these not be suitable.
Dietary supplements – Calcium is the primary mineral in our bones, so supplementing this could help to support bone formation and health. Vitamin D is also important, as it helps the body to absorb calcium more easily. A doctor can advise on the most relevant supplements for you, but you may find more useful information in our guide to the best supplements and vitamins for the elderly.
Hormone replacement therapies (HRT) – This can help women to preserve bone density in some cases. For those going through early menopause before the age of 45, they may be advised to take HRT until the age of 51 to increase oestrogen levels and protect against osteoporosis.

With or without treatments, it is important to undergo regular follow-ups with your doctor to ensure your bones are as healthy as possible, and to monitor your T Score over time, as this could inform further precautions you may need to take.

What lifestyle changes can support bone health?

Lifestyle changes can be helpful for older adults regardless of bone health, as there is usually a higher risk of falls or health conditions in this age group. Lifestyle changes are particularly important for those with osteopenia or osteoporosis.

Some of the most important lifestyle changes for those with these conditions might include:

Dietary changes – A diet rich in calcium is important for those with bone issues, which may mean consuming plenty of low-fat or fat-free milk or yogurt, beans, leafy greens and fortified foods like cereals. Speak to your doctor for the NHS recommended foods.
Reducing alcohol and quitting smoking – Studies show alcohol can increase the likelihood of developing osteoporosis, and suggest that a person who consumes 1-2 drinks a day has a 1.34 higher risk of osteoporosis compared to non-drinkers. Also, smoking has long been associated with osteoporosis risk. To support bone health, reducing alcohol intake and quitting smoking could help.
Vitamin D – Getting adequate amounts of vitamin D through safe sunlight exposure and supplements can help to support calcium absorption, and therefore bone health.
Fitness – By incorporating weight-bearing exercises into your fitness routine in a safe way, you can maintain muscle and support bone health. This could include things like walking, resistance training or lifting weights. You can learn more about fitness for older adults in our guide to fitness and exercise for the elderly.
Home adaptations – Making even small adjustments to your home could be important for avoiding falls and other injuries that could affect bones. For example, adding grab rails in problem areas, using a handrail on the stairs or a stairlift, and removing any trip hazards like loose rugs or clutter. You can learn more helpful information in our guide to home adaptations for disabled elderly people.
Footwear – Wearing supportive footwear can help to reduce your risk of falls and resulting bone issues. You can read more about this in our guide to specialist shoes for elderly people.

Home care – For those who struggle around the home or who worry about going out on their own, having home care in place to support movement and mobility at home and within their community can make a huge difference to safety and confidence.

How can home care support people with a low T Score?

Having a caregiver in the home can provide a level of support and protection for those with osteopenia or osteoporosis who may be more at risk of injury due to a low T Score.

Home carers can help with:

Medication management to support bone health, if prescribed by a doctor
Recognising signs of mobility problems
Attending medical appointments to monitor T Score and other health changes
Encouraging a healthy diet to support bone health and overall health
Encouraging an active lifestyle that helps to maintain muscle mass in a safe way
Providing emotional support if an osteoporosis diagnosis is worrying, or if an older person develops a fear of breaking a bone
Immediate support in case of falls or injuries

If you have been diagnosed with osteoporosis, or are caring for a loved one with this condition, you may benefit from the resources and support provided by the likes of:

The Royal Osteoporosis Society also has an Osteoporosis Risk Checker that could help if you are undiagnosed but feel you may have bone density issues.

Our experienced, supportive Care Professionals can help by providing expert support to those who live with osteoporosis or another bone issue. We understand that life with this condition can cause reduced mobility, self-confidence issues, and isolation due to fears of falling, so our friendly caregivers can ensure you maintain your quality of life without putting you at risk of injuries. Reach out to your local Home Instead office to discuss how we may be able to help you.

We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.

Michelle Tennant, Clinical Governance Lead

I am a Registered Nurse of 20 years and have been in the care sector since I was 17 years old, I have had experience in every role that exists in a care company, including Registered Manager, care consultant, recruiter, scheduling, auditing, complaints, and networking! My role in the National office is Clinical Governance Lead, and most recently have been working with DHSC and Chief Nurse Deborah Sturdy to develop a clinical governance framework for the delegated healthcare activities in social care, I am continuing to take the lead on our Healthcare at Home service and drive this in the network. In addition to my nursing role, I’m 5 years into my PhD in Aging at Lancaster University, with a key focus on the retention of Care Professionals in the social care sector.