Many women and some men get osteoporosis as they age.
Osteoporosis is a weakening of bone tissue. If you develop it, your risk of fracture is much greater. Even a minor fall or bump can lead to a broken bone in the hip, spine or wrist. But many do not even know they have osteoporosis, which is why it’s often called a silent disease.
Endocrinologist Ugis Gruntmanis, MD, director of Bone Health and Osteoporosis Services at Dartmouth Hitchcock Medical Center (DHMC), says there are ways to reduce your chance of getting fractures. He also says that loss of bone density can be stopped—and even reversed—with the right treatment.
How likely are you to get osteoporosis?
According to the most recent findings from the U.S. Centers for Disease Control and Prevention (CDC), almost 20% of women aged 50 and over, and just slightly more than 4% of men in this age group, develop osteoporosis.
But low bone mass—the precursor to osteoporosis—is even higher among adults aged fifty and over. About half of women and one-third of men have this condition, often classified as osteopenia.
How to build bone density when you are young
Until you are 30 years old, you can build bone density without medication.
Diet matters. Particularly important are vitamin D and calcium.
Weight-bearing exercises like walking, jogging and climbing stairs also help maintain and build bone density when you are young. Strength and resistance training are particularly good for bones, muscles and tendons.
But as you age and your body loses its ability to build bone, your focus should turn to bone density maintenance.
“Good intake of calcium, vitamin D and staying active is important,” says Gruntmanis.
Why loss of bone density and quality can be dangerous
The big risk of bone density loss is fractures, which are also more likely among older adults, particularly women.
One in two women and one in four men who are 50 years or older will get a fracture. “Fractures are more common than breast cancer, stroke and heart attack combined,” says Gruntmanis.
Breaking a bone is often the first sign of osteoporosis, which is considered a silent disease because you can’t feel your bones weakening.
“If a patient breaks an ankle or forearm by slipping off a curb or compresses a bone when lifting something heavy, we know they have osteoporosis regardless of what bone density shows. Low-impact fractures are something bones should normally withstand,” says Gruntmanis.
When to start screening
Timely screening, diagnosis and treatment of osteoporosis can help prevent fractures.
“We check bone density to predict your risk of fracture,” says Gruntmanis.
Bone density testing is recommended for women over 65 and men over 70, and even earlier if you have certain risk factors.
Among the risk factors are certain medications for depression or breast cancer, family history, whether you are Caucasian, not getting enough calcium and vitamin D, and how active you are.
Women with heightened risks should begin screening at menopause when there is a drop in the production of estrogen, which helps maintain bone health.
Talk to your healthcare provider to determine when you should begin screening.
What you can do to prevent fractures past 30 years old
While strength or resistance training is unlikely to increase bone density for people already in their mid-thirties or beyond, exercise can build muscle, lowering the risk of falling and other injuries.
Building strength in areas that might otherwise be weakening, like your core, can help you better maintain your balance.
There are many types of strengthening exercises that are safe and age-appropriate.
“For example, doing yoga or Tai Chi will make you not as likely to fall as much and if you don’t fall as much, you will have fewer fractures,” says Gruntmanis.
Staying active in general is important, too. “Walking is a great exercise for bones in general,” he says, cautioning that taking up a new form of more strenuous exercise when you are older may be ill-advised due to the increased risk of injury.
A good diet also helps maintain, though not increase, bone density as you age. Because many people do not get enough vitamin D or calcium in their diets, a vitamin supplement may be necessary.
Whatever changes you make to your diet or lifestyle, choose ones that you can maintain, says Gruntmanis.
Why you may need medication
Also, be aware that even changes to diet and activity level may not be enough.
If you are diagnosed with osteoporosis, you may need medication, which is the only way that studies show to reverse bone loss among those beyond their early thirties.
“All FDA-approved medications reverse bone loss and decrease fracture risk,” he says.
One more point to note, says Grunmantis, is to keep an eye on your height.
“Normal height loss lifelong is up to an inch. If someone has lost one-and-a-half, two or three inches, it is very likely possible that you have a fracture in your spine which is asymptomatic.”