Osteoporosis in the elderly is common, but it’s not part of your natural aging process. Diet modifications, lifestyle changes, and medication can help slow down this disease of brittle bones.

Osteoporosis has become a familiar term, and many people think it’s just a part of life. While it’s true that you do lose bone density as you age, it isn’t certain you’ll develop osteoporosis.

Osteoporosis is a bone disease, meaning it’s not part of your typical aging process. It occurs when your bone mineral density and strength deteriorate due to imbalances in your skeletal remodeling process.

Anyone of any age can develop osteoporosis. But because aging creates an environment of change in your bone structure already, osteoporosis is common in the aging population.

Osteoporosis in older adults is caused by an imbalance in their bone remodeling process. It occurs when the resorption of old or damaged bone tissue outpaces your body’s production of new bone tissue.

This altered process of bone remodeling causes your bones to lose mineral density. Large gaps form in the framework and structure of your bones, causing them to weaken and become prone to fractures.

As you age, your bone remodeling process slows. You naturally lose bone density. When you lose more than what’s considered healthy, you may be living with osteoporosis.

What’s classified as low bone density?

In the aging population, bone mineral density tests assign you a T-score. A T-score is the difference between 0, the bone density baseline of a healthy adult, and your bone density reading.

T-scores of 1 or higher signify healthy bone. If you score -1 to -2.5, you may meet the criteria for osteopenia. This is a clinically significant level of low bone density that often comes before osteoporosis.

Osteoporosis may be present when your T-score is -2.5 or lower.

Every time your T-score decreases by a point, your risk of broken bones increases.

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Risk factors of osteoporosis in the elderly

The exact cause of osteoporosis isn’t well understood. Not every person entering their senior years develops osteoporosis, and experts aren’t sure why some do and some don’t. Nutrition, lifestyle, and body characteristics may all play a role.

No single trait has been identified as a universal cause, but researchers know that certain factors increase your likelihood of developing this disease.

Factors linked to an increased risk of osteoporosis include:

  • having estrogen as your dominant reproductive hormone
  • low levels of reproductive hormones
  • a slender body frame
  • a family history of osteoporosis
  • nutritional deficiencies
  • living with other medical conditions
  • long-term medication use
  • excessive alcohol consumption
  • smoking
  • physical inactivity
  • being a white male or female or being an Asian female

How common is osteoporosis in the elderly?

In the United States, approximately 10 million people ages 50 years old and older live with osteoporosis.

It affects an estimated 1 in 5 women 50 years old and older and 1 in 20 men 50 years old and older.

Globally, a 2021 review of studies found 21.7% of older adults live with osteoporosis, with the highest prevalence noted in Asia, the United States, and Europe.

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Osteoporosis is sometimes referred to as a “silent” disease because of how few outward symptoms it shows — if it shows any at all.

Symptoms include:

  • decreased body height
  • posture changes
  • shortness of breath
  • back pain
  • multiples fractures or breaks
  • movement instability

In older people, osteoporosis can be complicated by other age-related health changes. You may be more susceptible to falling, for example, due to balance and coordination changes. Falling when you live with osteoporosis can mean a broken bone or fracture.

You may not be able to recover as you did in your younger years, making it more likely that damaged bone won’t heal correctly. This can increase your chances of a break or fracture causing major pain and long-term impairment.

Osteoporosis can even compromise your independence. Mobility limitation is a leading cause of long-term care facility admission.

Mobility limitations aren’t the only concern. Osteoporosis-related bone fractures in areas of your body like your spine and hip are associated with a higher mortality rate for seniors.

Being immobile due to one of these major bone complications can increase your risk of life threatening complications like pneumonia or cardiovascular events.

Osteoporosis treatment is approached the same way no matter your age when you receive the diagnosis. It’s a dynamic process that aims to slow or prevent new bone loss and lower your fracture risk.

Everyone’s treatment program will vary. A doctor will take into account your overall health, mobility, how much bone you’ve lost, and any coexisting medical conditions.

Treatment usually involves medications specifically intended to help strengthen your bones, such as:

  • anabolic agents
  • biologics
  • hormone-based therapies
  • bisphosphonates

Along with medications, a doctor may recommend:

  • dietary supplements
  • alcohol limitation
  • quitting smoking
  • avoiding caffeine
  • regular exercise
  • at-home fall prevention strategies (like installing hand railings)

Can osteoporosis be reversed in the elderly?

Osteoporosis isn’t curable. But you can improve your bone density and slow or prevent new bone loss. How successful this process is will depend on factors like your age and how much bone density you’ve already lost.

If you’re walking the line between osteoporosis and osteopenia, for example, you may be able to regain enough bone density to lower your fracture risk.

But even with medications and lifestyle changes, you may not be able to make up for the amount of bone you’ve lost once you’ve entered your senior years.

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It may not always be possible to prevent osteoporosis as you age. But the sooner you start being proactive about your bone health the better.

Osteoporosis isn’t something that happens overnight. It’s a progressive state of bone loss, which is why factors like exercise, diet, and substance use have such an impact on it.

Ways you can help prevent osteoporosis include:

Osteoporosis in older adults is common. It affects millions of people in the United States and more than 21% of the global older adult population.

Your bones naturally lose density as you grow older, but osteoporosis isn’t a normal part of aging. Exercising, meeting your nutritional needs, and steering clear of smoking and excessive alcohol use can help reduce your risk of this bone disease later in life.