What should you know about osteoporosis in old age?

Bone loss may develop quietly, without pain, until a fracture occurs. Fractures can involve the hip, spine, wrist or another bone. A vertebral compression fracture may cause new back pain, a change in posture or loss of height. Frailty, reduced vision, poor balance and medicines that cause drowsiness can add to fall risk, but they are separate issues that can be addressed.

A clinician may review previous fractures, family history, nutrition, activity, medicines and conditions that affect bone. A bone density scan helps estimate bone strength. The result is considered alongside your age, falls and overall health rather than interpreted in isolation.

Keep a regular routine of safe weight-bearing movement and strength exercises suited to your ability. Improve lighting, remove loose rugs, add handrails where needed, and have eyesight and footwear checked. Eat varied meals that provide adequate calcium and protein, and discuss vitamin D with your clinician rather than starting high-dose supplements yourself.

If osteoporosis is diagnosed, treatment may combine fall prevention, exercise, nutrition and medication. Options can include calcium supplementation, vitamin D supplementation or bisphosphonate therapy, depending on fracture history, kidney health, dental concerns and other medicines.

After a fall, seek prompt care for hip or groin pain, inability to stand, a shortened or turned-out leg, new severe back pain, or pain that prevents normal use of an arm or leg. Urgent assessment is also sensible after a minor event if you have known osteoporosis. Do not assume that a fall without bruising has caused no injury.

Should I have a bone density scan or a review of fracture risk? Which balance and strength exercises are safe for me? Could any of my medicines increase falls or affect bone? How should calcium and vitamin D fit with my diet and prescriptions? What symptoms after a fall should lead me to urgent care?