Keeping Bones Fit and Healthy as You Age

Most people have been told at least once in their life to drink milk so they will have strong bones when they grow up. As all of us continue that process of growing up into older adulthood, maintaining strong and healthy bones can be of even greater importance in order to prevent serious fractures, brittleness and significant loss of bone mass.

Although many people think of the skeleton as a framework, bone is living tissue composed primarily of protein and calcium. Like skin and other body tissues, old bone is continually replaced by new bone throughout our lives.

A degree of bone loss is a normal part of the aging process. For example, by time someone who is biologically female is 25, their skeleton will have reached its maximum amount of bony tissue. After the age 35, the loss of old bone exceeds the growth of new bone, increasing the risk of fractures.

If someone loses too much bone, they can develop osteoporosis — a condition that causes bones to become thinner, fragile, and more easily broken. Because bone loss happens gradually, a broken wrist or hip is often the ﬁrst sign of osteoporosis. Osteoporosis also causes spinal fractures when weak bones in the back are compressed by the weight of the body.

Hip fractures caused by osteoporosis are the leading cause of hospitalization in older adults. Many people who break a hip will enter a nursing home either as a permanent resident or for rehabilitation. Sadly, even treated hip fractures have a 21 percent one-year mortality rate due to complications, particularly pneumonia. That one-year mortality rate skyrockets to 70 percent if the fracture is left untreated.

Symptoms of osteoporosis

Osteoporosis occurs more often in biological females after menopause, although older males can also develop the disease. Most people are unaware they have osteoporosis when the disease is in its early stages. The ﬁrst signs of bone loss include:

Loose teeth or gum disease resulting from bone loss in the jaw.
Loss of height, a rounded upper back or stooped posture.
Fractures especially of the wrist, vertebrae or hips.
Back pain.

Osteoporosis risk factors

Heredity is a major factor in the development of osteoporosis. One way to determine whether or not you or your older loved one is at risk is to examine family history for relatives who also experienced bone loss late in life. Racial and ethnic background can also play a role, as White and Asian individuals are at greater risk for osteoporosis than Black or Hispanic individuals.

Other risk factors include:

Having short or small-bones with less bone mass.
Experiencing early menopause. Estrogen typically protects from abnormal loss of bone tissue, so when estrogen levels decrease following menopause, the risk for bone loss increases.
Taking certain drugs prescribed for arthritis, asthma, inﬂammatory bowel disease, thyroid disorders and cancer, especially if the drugs are taken in high doses or for a long time.
Smoking.
Drinking large amounts of alcohol, coffee, tea or other drinks with caffeine.
Lack of exercise.
Low intake of calcium from food or supplements.

Diagnosing osteoporosis

The National Osteoporosis Foundation recommends the older adults 65 and over take a bone mineral density test, which is a painless 30 minute scanning procedure that measures the density of bones in the spine, hips and wrists. Medicare covers the cost of the test once every 24 months.

Diets for healthy bones

All older adults should make an effort to consume their recommended 1,000 to 1,500 milligrams per day of calcium. Good sources of calcium include:

Milk, whether animal or fortified plant-based
Yogurt
Cheese
Canned sardines and salmon (with bones)
Collard, turnip, beet or mustard greens
Kale
Bok-choy
Okra
Almonds
Edamame
Fortified orange juice
Whey protein

If you or an older loved one is struggling to get enough calcium through diet choices, calcium supplements may be worth considering.

Exercises to improve bone health

While exercising, you or an older loved one should stick to activities that are both personally enjoyable and that increase bone and muscle tissue. Some options to consider include:

Walking
Stretching
Strength training with weights or resistance bands
Tai chi
Low intensity dancing

Older adults over the age of 65 should consult with a doctor before beginning a new workout regime to make sure it is safe for them to do so.
Medications and bone health

Several oral and injectable drugs are available to stop bone loss, reduce the risk of fractures and help the body rebuild bone. Some of these medicines have signiﬁcant side effects and may not be right for all older adults. A doctor can assist in ﬁnding the best medication to maintain healthy bones with the fewest side effects.

Resources

For more information on osteoporosis, visit these websites: