A fracture is a medical term for a broken bone. While often the result of acute trauma, many fractures, particularly in older adults, occur because of weakened bone structure. Reducing the likelihood of a bone break requires a multi-faceted approach that addresses both the internal integrity of the skeletal system and the external risks that lead to falls. This guide details preventative strategies, from dietary intake and physical activity to medical assessment and environmental changes, necessary to maintain long-term bone health and fracture resistance.
Nutritional Foundation for Bone Density
Building and maintaining a strong skeletal structure depends heavily on a consistent supply of specific dietary components. Calcium is the primary mineral required, providing the physical building blocks that give bone tissue its hardness and rigidity. Adults under 50 generally require a total daily intake of 1,000 milligrams (mg) of calcium from all sources.
This recommendation increases to 1,200 mg per day for women aged 51 and older and men aged 71 and older. When the diet lacks sufficient calcium, the body withdraws the mineral from the bones to support other critical functions, leading to low bone mass. Good sources include dairy products like milk and yogurt, as well as fortified foods such as certain cereals and juices.
Vitamin D is equally important, as its primary function is to enable the body to absorb consumed calcium. Most adults under 70 should aim for 600 International Units (IU) per day, while those 70 and older need 800 IU daily. Since few foods naturally contain significant amounts of Vitamin D, many individuals require supplementation to reach recommended levels.
A balanced diet that includes a variety of vitamins and minerals supports overall skeletal health. Calcium supplements are best absorbed when taken in doses of no more than 500 to 600 mg at a time.
Strategic Physical Activity and Balance Training
Physical activity is a direct mechanical stimulus that signals the body to strengthen its bone tissue. This effect is primarily achieved through two distinct types of movement: weight-bearing exercises and resistance training. Weight-bearing activities involve moving the body against gravity while remaining upright, and are categorized as either high-impact or low-impact.
High-impact examples, such as jogging, dancing, and jumping rope, provide a greater stimulus for bone growth but may not be appropriate for everyone. Low-impact options, including brisk walking, using an elliptical machine, or stair-step machines, offer a safer alternative that maintains bone strength. Engaging in weight-bearing aerobic exercise for at least 30 minutes on most days of the week is beneficial for bone density.
Resistance training involves moving muscles against an external force, such as free weights, resistance bands, or body weight. This activity creates tension on the tendons, which pulls on the bones to stimulate new bone formation. Incorporating resistance exercises at least two days a week helps to increase muscle mass, which acts as a protective shield around the skeletal structure.
Focused balance and flexibility training are a primary defense against fractures by preventing falls. Activities like Tai Chi and yoga improve coordination, body awareness, and reaction time. Improving dynamic function through these exercises enhances the ability to navigate the environment safely.
Assessing Personal and Medical Risk Factors
Certain physiological and medical conditions significantly increase an individual’s susceptibility to fractures, requiring proactive assessment and management. The most significant of these is osteoporosis, a disease characterized by low bone mass and deterioration of bone tissue structure. This leads to skeletal fragility and a heightened risk of fractures, often from minimal trauma.
Age is a major factor, with bone density naturally decreasing over time, particularly in postmenopausal women due to reduced estrogen levels. Physicians utilize Dual-Energy X-ray Absorptiometry (DEXA) to measure bone mineral density (BMD) at sites like the hip and spine. This non-invasive scan produces a T-score, which compares the patient’s BMD to that of a healthy young adult.
Screening with a DEXA scan is recommended for all women aged 65 and older and men aged 70 and older, as well as younger individuals with specific risk factors. High-risk factors include a prior fragility fracture, low body weight, or long-term use of certain medications. Glucocorticoids, a type of steroid, are a notable example that can significantly accelerate bone loss when taken for three months or longer.
For patients identified as high-risk, a physician may recommend preventative pharmacologic treatment to slow bone loss or build new bone. Bisphosphonates, such as alendronate, are often the first-line choice to reduce the risk of hip and vertebral fractures. Other options, including denosumab or bone-building agents like teriparatide, are reserved for those with very low bone density or when first-line treatments are not tolerated.
Modifying Environments to Prevent Falls
The majority of fractures occur as the result of a fall, making environmental modification a crucial preventative strategy. A simple home safety check can identify and address external hazards that increase the risk of accidental slips and trips. Removing throw rugs or securing them firmly with non-slip backing eliminates a common cause of tripping.
Improving home safety involves several key modifications:
- Improving lighting throughout the home, especially in hallways, stairwells, and bathrooms.
- Installing nightlights in bedrooms and along pathways to prevent falls during nighttime trips.
- Installing secure grab bars near the toilet and inside the shower or tub in areas with moisture.
- Ensuring stairways have sturdy handrails installed on both sides, and applying non-slip treads or high-contrast tape to step edges.
Managing personal functional factors also contributes significantly to spatial awareness and fall avoidance. This includes wearing proper, supportive footwear indoors and having regular vision and hearing checks.