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Eldercare at Home: Bone Weakness

Caregiving How Tos

Understanding the Problem

As people age, their bones begin to thin and lose strength. Bone thinning is called osteopenia. Severe bone thinning to the point where a person is at a high risk for broken bones (fractures) is called osteoporosis. Warning signs of osteoporosis include loss of height or a stooped posture. However, most people are not aware of their bone loss until a bone is broken.
Up to the age 75, osteoporosis is more common in women than in men. At that point, men "catch up." Women who develop osteoporosis usually do so after menopause. After menopause a woman's body stops producing estrogen, one of the hormones that keep bones strong. Without estrogen, bones may become softer, weaker, and more likely to break. Women who are most at risk for osteoporosis have a family history of the disease, are thin, smoke, and did not take hormones after menopause. Other risk factors include a diet low in calcium and Vitamin D, lack of exercise and lack of exposure to the sun, smoking and excessive alcohol or caffeine use, history of an overactive thyroid gland, and taking certain medicines such as corticosteroids and medicines used to treat seizures. For reasons that are unclear, Caucasians and Asian-Americans are more likely to develop osteoporosis than African-Americans. Older men are also at risk for osteoporosis, particularly after prolonged inactivity.
For people with osteoporosis, any little bump, trip, or fall may be all that is necessary to cause a broken wrist, hip, or back bone. Sometimes a bone can break first, and then the person falls. Also, an older person's bones may take longer to heal after a break.
Once a person has broken a bone, inactivity must be avoided at all costs, because an older person who is laid up for months healing is unlikely to resume previous levels of activity. After that experience he or she may be afraid to go out or walk. For this reason, orthopedists recommend fixing most hip fractures by operating on them. The person can get up and start walking with the help of a physical therapist almost immediately. Unfortunately, some older people who have fallen cut back on exercise for fear of falling again. Lack of exercise will further weaken bones and muscles and actually make falls more likely. So it is important for older people to be as active as possible, even after a fall.
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