Healthy bones help us stay active and independent, from taking daily walks to carrying groceries and enjoying time with family. A fracture can interrupt those routines and sometimes make it harder to live independently during recovery. As we age, bones can gradually lose strength without causing pain or other obvious symptoms. Understanding these changes gives you an opportunity to address risk factors early and make informed decisions about screening and prevention.
How Bones Change With Age
Bone is living tissue that is constantly being renewed. Your body removes older bone and replaces it with new bone through a process called remodeling. As you get older, bone loss can outpace bone formation, gradually reducing bone density and strength.
Women often experience faster bone loss around menopause as estrogen levels decline. Men also lose bone as they age and can develop osteoporosis, a condition that weakens bones and makes fractures more likely. The hips, spine, and wrists are common fracture sites. Low bone density, sometimes called osteopenia, can also increase fracture risk and deserves attention.
Understand Your Personal Risk
Age is one factor in bone health. A parent’s history of osteoporosis or hip fracture, low body weight, smoking, heavy alcohol use, and prolonged inactivity can also increase risk. Certain medical conditions and medications contribute to bone loss, including some digestive and hormonal disorders and long-term use of oral corticosteroids such as prednisone.
Share this history with your physician, including any broken bones in adulthood. A fracture after a fall from standing height may indicate that your bones need closer evaluation. New back pain, loss of height, or a change in posture also warrants a discussion, since these can be signs of a spinal fracture.
If you smoke, ask your physician about support and treatment to help you quit. Avoiding heavy alcohol use can also help protect your bones and reduce your risk of falling. These are changes you can work on at any age.
When to Ask About Bone Density Testing
A bone density test, usually called DXA or DEXA, measures bone density using low-dose X-rays, most often at the hip and spine. The test is quick and painless. Your physician considers the results together with your medical history and other risk factors to estimate your likelihood of a fracture and guide care. Your physician may also use a tool called FRAX to estimate your risk of a hip fracture or another major osteoporosis-related fracture over the next 10 years.
The U.S. Preventive Services Task Force recommends screening women age 65 and older. It also recommends screening postmenopausal women younger than 65 when a clinical risk assessment shows an increased risk of an osteoporosis-related fracture.
Recommendations for men vary among medical organizations. The Bone Health and Osteoporosis Foundation recommends testing men age 70 and older, and men ages 50 to 69 with risk factors. A previous fracture or a condition or medication that affects bone strength may warrant evaluation sooner. The timing of repeat testing depends on your results and circumstances.
Eat to Support Bone Health
Calcium helps maintain bone structure. Adults ages 19 to 50 need 1,000 milligrams daily, as do men ages 51 to 70. Women age 51 and older and men age 71 and older need 1,200 milligrams. These totals include calcium from both food and supplements.
Milk, yogurt, calcium-fortified plant beverages, calcium-set tofu, and canned salmon or sardines with edible bones can help meet those needs. Check labels, especially on plant beverages, because calcium content varies. If your diet falls short, discuss whether a supplement would help and how much you actually need.
Vitamin D helps your body absorb calcium. The recommended daily intake is 600 international units (IU) for adults through age 70 and 800 IU beginning at age 71. Fatty fish and fortified foods provide vitamin D, and some people need supplements. Your physician may recommend a different amount based on your health or a diagnosed deficiency.
Adequate protein and overall nutrition matter, too. Include protein sources such as fish, poultry, beans, eggs, tofu, or yogurt in regular meals. If a poor appetite, restrictive diet, or digestive condition makes eating well difficult, your physician or a registered dietitian can help you address those concerns.
Choose Exercise That Supports Bones and Balance
Weight-bearing activities, including brisk walking, dancing, and climbing stairs, place a beneficial demand on bones. Resistance training with weights, resistance bands, or your own body weight also supports bone and muscle strength. Balance exercises, such as tai chi, can help improve stability and reduce falls.
For adults who are able, general activity guidance includes at least 150 minutes of moderate-intensity aerobic activity each week and muscle-strengthening activities on at least two days. Older adults should include balance training as well. Start at a manageable level and gradually increase activity as your abilities allow.
If you have osteoporosis, a previous fracture, or difficulty with balance, ask your physician or a physical therapist to help you choose appropriate exercises. Some activities may need to be modified to reduce injury risk. A routine that fits your health and physical abilities can make regular movement easier to maintain.
Reduce Your Risk of Falls
Preventing falls is an important part of protecting bone health. Check your home for loose rugs, electrical cords, clutter, and poorly lit pathways. Secure handrails on stairs, add bathroom grab bars where needed, and wear shoes that fit well and provide traction.
Keep up with vision care, and tell your physician if you feel unsteady or have fallen, even if you were not injured. A review of prescription medications, sleep aids, and over-the-counter products may identify medicines that contribute to dizziness or drowsiness. Your physician can help determine whether changes to your treatment or additional balance training would be useful. CDC
When Treatment May Be Needed
If you have osteoporosis or a high risk of fracture, your physician may recommend medication along with nutrition, exercise, and fall prevention. Some medicines slow bone breakdown, while others help build new bone. The choice depends on your fracture history, bone density, overall health, and other factors. Some people with osteopenia also benefit from medication when their overall fracture risk is high.
Follow-up visits help your physician assess how treatment is working and decide when to repeat testing. Discuss side effects or concerns before changing or stopping a prescribed medicine. Ongoing care can also address medical conditions that contribute to bone loss.
At your next preventive visit, ask whether your fracture risk has been assessed and whether bone density testing is appropriate. Bring a list of medications and supplements, along with any history of fractures or recent falls. These details help your physician recommend practical steps suited to your health.
Personalized Preventive Care at Dedication Health
Dedication Health provides concierge primary care in Chicago’s North Shore, with longer visits and an emphasis on prevention and personalized care. For adults looking for a concierge physician, this approach allows time to discuss concerns such as bone health within the context of their overall health. Learn more about concierge medicine at Dedication Health and membership options.