Falls might not seem like a big deal to many, but for older adults or those with or at risk for the bone-thinning disease osteoporosis, they can have serious consequences. Falling can lead to severe injuries, make daily tasks harder, reduce your quality of life, and take away the freedom to live independently. In some cases, falls can even be life-threatening.
Endocrinologist Jessica Rachel Starr, MD, an Assistant Attending Physician at Hospital for Special Surgery, says she sees at least one or two patients per day who she wishes she met a decade before — not after — a fracture.
She recalls one patient who was told to start osteoporosis treatment 10 years ago but resisted due to fear. “Her friends told her scary things about [the medication]. And now she’s stuck in an assisted living [facility] because she broke her hip after breaking her spine and her family wouldn’t allow her to be home anymore,” says Dr. Starr. “And I think that’s really sad and states that manifestation of a disease that, truthfully, is very treatable and preventable.”
11 Steps for Fracture Prevention
Not only is osteoporosis preventable, but so are the fractures that can result from it. With proactive measures, regular screenings, and lifestyle adjustments, you can strengthen your bones and reduce the risk of debilitating injuries. Here are a few steps to consider.
Re-Evaluate Your Home
As you get older, it’s smart to re-evaluate your home, even if you’ve been living there for decades. “What was safe when you were 40 is not okay anymore when you’re 75 or 80,” says Dr. Starr. Look out for potential hazards like loose rugs. Make sure there’s proper lighting, especially near staircases, and that banisters are sturdy. If your bathtub is high, consider installing support handles to help you get in and out safely.
Mind Your Movements
Something as simple as being more conscious of your everyday movement can be a powerful fracture prevention step. “Slow down and don’t go up and down the stairs carrying things,” says Dr. Starr. “Go up and down the stairs holding the banister.”
Choose Smart Footwear
Wear comfortable shoes with good support, a broad heel, and non-slip soles. And avoid slipper with worn-out soles, says Dr. Starr, or heels in the rain or snow.
Don’t Brave the Weather
Unless necessary, stay home during slippery weather conditions like ice, snow, or heavy rain. If possible, have someone else run errands for you. “I can’t tell you how many people come into the office when it’s terrible weather to see me just because they have an appointment. And I’m like, ‘Oh my goodness, you have advanced osteoporosis, you’re out in ice; you’re out in the rain. That’s not what you should be doing.’” If you can’t wait to reschedule your in-person visit, consider asking about telehealth options to stay safe and still get the care you need.
Pay Attention to Your Eyewear
It’s essential to keep your glasses clean and in top condition to avoid blurred or obstructed vision, which could lead to falls. If you wear bifocals, use extra caution on stairs; the change in lens magnification can distort your depth perception. Additionally, on bright days, wearing sunglasses can reduce glare, helping you spot potential tripping hazards and further reduce your risk of accidents.
Schedule Regular DEXA Scans
Be proactive and prioritize early screening before encountering a fracture. This includes a DEXA scan, which is a low-radiation X-ray that checks your bone density and can pinpoint osteoporosis or its risk. Consistent screenings can also help track bone health. Women above 65 and men over 70 should have regular checks. Your doctor might recommend more frequent scans based on your health, family history, and certain medications.
However, if you’ve had a fracture, especially in areas like the lumbar vertebrae, be aware of the DEXA scan’s limitations. “Once you fracture one of the four lumbar vertebrae that we use to interpret bone density, you can’t use that result in a bone density test because it’s invalid,” says Dr. Starr. In this case, your provider will need to make a decision based on clinical observation.
Prioritize Your Treatment
If you’re already living with osteoporosis, it’s crucial to regularly discuss your treatment plan with your doctor. Ensuring you’re on the most effective treatment can make a significant difference in protecting your bones and preventing fractures. There are various classes of treatments available. For instance, antiresorptive treatments help maintain bone structure while anabolic treatments stimulate bone formation. By understanding and choosing the right approach, you can actively work toward better bone health.
Ask About Your Medication
Talk with your doctor about the medications you are taking and whether they have any side effects, like making you feel dizzy or unsteady, that could lead to falls. Having these facts ahead of time can help you stay safe and avoid any unexpected tumbles.
Make Smart Lifestyle Choices
If you smoke, consider quitting. Cigarette smoking can weaken bone density and heighten osteoporosis risks. Remember, it’s never too late; quitting even later in life can help counteract bone loss tied to smoking, reducing the risk of subsequent fractures.
Secondly, moderate your alcohol intake. Aim for no more than one drink daily for women and two for men. Excessive drinking can elevate your chances of developing osteoporosis. Plus, alcohol can affect your balance and reflexes, reaction time, and ability to judge distances, which can all lead to an increased risk of falling.
Do Weight-Bearing Exercise
Weight-bearing exercises like walking or resistance training are crucial for protecting against osteoporosis and safeguarding bone density in those with osteopenia or osteoporosis. As muscles and bones resist gravity’s pull during these activities, the bone health benefits increase with the intensity of the load.
Dr. Starr notes that research indicates certain weight-bearing activities can reduce the risk of hip fractures by up to five percent. Weight-bearing exercises enhance balance, posture, and agility, thereby decreasing the chances of falls and related injuries.
“If you become inactive because you are worried you are going to fall and fracture, that actually will become a self-fulfilling prophecy,” warns Dr. Starr. “If we don’t use our bones, if we’re not doing weight-bearing exercises, we will then lose our bone from inactivity.”
Note: Exercise safety is key to preventing fractures, so talk to your health care provider to develop an appropriate workout routine for you.
Monitor Your Weight
Losing weight unintentionally as you get older can be a sign of becoming frail. Dr. Starr often encounters patients who’ve lost weight and aren’t sure why. It might be due to life changes like a loved one’s passing or children moving out, she says. “That kind of unintentional weight loss is actually very bad because it’s also associated with severe muscle loss, known as sarcopenia,” says Dr. Starr. Weakened muscles heighten the risk of falls, and with compromised bone strength, fractures become more likely.
Remember, a little prevention and care today goes a long way. By embracing regular check-ups and making small, mindful changes in our daily lives, we’re not just looking after our bones but ensuring brighter, more active days ahead.
Learn more about what you can do to prevent fractures and strengthen your bones at StrongBonesAndMe.org.
This article was made possible with support from Amgen.
Bone Health & Osteoporosis Foundation. Bone Density Testing. https://www.bonehealthandosteoporosis.org/patients/diagnosis-information/bone-density-examtesting/.
Bone Health & Osteoporosis Foundation. Nutrition. https://www.bonehealthandosteoporosis.org/patients/treatment/nutrition/.
Interview with Endocrinologist Jessica Rachel Starr, MD, an Assistant Attending Physician at Hospital for Special Surgery.
International Osteoporosis Foundation. Falls Prevention. https://www.osteoporosis.foundation/health-professionals/fragility-fractures/falls-prevention.
Theodore MD, Miclau. Secondary fracture prevention: global approaches. OTA International. June 2022. https://journals.lww.com/otainternational/Fulltext/2022/06001/Secondary_fracture_prevention__global_approaches.1.aspx.