Why Do Bones "Break" in the Elderly?

A simple fall that results in a fracture usually means osteoporosis. It's a "silent disease"—with no visible symptoms, often discovered only when a fracture occurs.

What Is Osteoporosis?

The process of bone resorption outpaces bone formation—the bone becomes thin, porous, and fragile. This is especially true for women after menopause.

Risk factors: Early menopause, corticosteroid therapy, vitamin D deficiency, a sedentary lifestyle, smoking, alcohol.

The Most Common Fractures

Femoral neck (hip) fracture—the most serious. One-year mortality rate: 20-30%. → Hip Replacement

Wrist fracture (distal radius)—often the first sign of osteoporosis.

Vertebral compression fractures—cause back pain, loss of height, and kyphosis (a hunched posture).

Tibial plateau fracture—in the elderly with osteoporotic bone, minor trauma can cause a fracture.

Screening—DEXA Osteodensitometry

The standard investigation, it is quick and painless.

Who should be screened:

All women over 65
Postmenopausal women under 65 with risk factors
Men over 70
Anyone with a fragility fracture
Patients on corticosteroids

Prevention

Vitamin D and calcium—supplementation under medical supervision
Weight-bearing exercises—walking, dancing, balance exercises
Fall prevention—good lighting, removing rugs, installing grab bars, wearing non-slip shoes
Quitting smoking, limiting alcohol
Medication—bisphosphonates, denosumab, if a DEXA scan confirms osteoporosis

The Key Message

Prevention is incomparably simpler than treatment. If you are over 50 and have not had a bone density scan, talk to your family doctor. If you have an elderly parent, help them make their home safe to prevent falls.

For context, see the dedicated page on hip replacement, and if you want to go deeper, read aboutthe causes of hip pain and abouthip replacement.

Osteoporosis and the Risk of Fractures in the Elderly