Why 60+ year old males need an annual DEXA body composition scan
It’s about preventive care and aging. We normally head straight to the GP for all sorts of male issues that arise; Check up’s here and there and a yearly health assessment. But who’s measuring and monitoring your bone density, fat mass and muscle mass each year. It’s certainly not your GP. Not unless they are referring you for a DEXA body composition scan.
There are three very important markers of health that need checking each year. These markers are very important in assisting your GP review your cardiovascular risk and fracture risk. Those markers are:
• Visceral adipose tissue
• Muscle mass
• Bone density
Higher visceral fat (the fat underneath your abdominal muscles around our major organs) is associated with higher risk of diabetes mellitus, cardio- and cerebrovascular diseases, obstructive sleep apnoea, cancer, hip fracture, frailty, and mortality. Therefore, we need visceral fat assessment, which is specific, accurate, easily available, not expensive, and safe.
Unfortunately, your waist does not make a distinction between visceral fat and subcutaneous fat (the fat under your skin or the fat you can grab a hold of). Nor is there a distinction between fat accumulation and enlargement of the abdomen due to other reasons (accumulation of fluid) either. Many GP’s still choose body mass index (BMI) over DEXA, however BMI does not reflect general fatness because it is influenced by muscle mass and water retention.
As we age muscle mass decreases, and this is known as sarcopenia. There is now a consensus on the definition and diagnosis of sarcopenia established by the European Working Group on Sarcopenia in Older People. A combination of low muscle mass, low muscle strength and poor physical performance (walking speed) all help to diagnose sarcopenia. Low muscle mass is defined as muscle mass divided by height squared. The cut-off point for sarcopenia by DEXA is 7.26 kg/m2. This is an underutilised accurate measure to ensure your muscle mass is not decreasing as you age.
Bone density is another measure males particularly tend to ignore and categorise as more of a female problem. However, more than a quarter of all people with osteoporosis are men. Bone health needs to be checked and monitored, like any other health issue.
So, there we have it. By having one rapid, less expensive, and less irradiating assessment than CT you can monitor your fat mass, muscle mass and bone density and keep check of your cardiovascular risk and fracture risk.
DR JARROD D. MEERKIN PhD AEP ESSAF