Strengthening Bones & Balance: Latest Research on Osteoporosis and Falling for Older Adults

Osteoporosis is often called a ‘silent disease’ as symptoms are not apparent until a fracture occurs. Yet it is very common, affecting over 10 million Americans. Osteopenia, often referred to as the first step towards osteoporosis (when bone density is lower than normal, but not at the threshold for osteoporosis), is believed to affect up to 34 million people. For people with either condition, a fall can result in serious fractures, which can have a cascade effect of reduced mobility and loss of independence, even death.

What does the latest research tell us about preventing osteoporosis and how to treat it once we have it? Is there anything we can do to prevent falling if our bones are weak?

Understanding Osteoporosis

Our bones are living tissue, and we build and renew them throughout life. We reach peak bone density in our 30s, after which our ability to replace bone decreases and they become weaker. Women are particularly at risk for osteoporosis after menopause, but the condition affects many older men also. Knowing your family history (did family members suffer from osteoporosis or osteopenia) can help you and your physician minimize the risks and take action that’s personalized to you. There are a number of medications which have proved to be able to slow bone loss, or even reverse it. There are also a number of lifestyle factors which can slow down bone density loss, and the greatest success is seen from those who combine medication and lifestyle changes.

Falls

Risk of falling also typically increases with age, and a fall can have a catastrophic impact on quality of life. 1.5 million hip fractures per year are attributed to osteoporosis, most of which occur as the result of a fall. A fall can also be fatal — in fact, across all age groups, falling is the leading cause of trauma death. For those living with weakened bones, taking a proactive approach to both bone health and fall prevention is vital.

Latest Research

The US Preventive Services Task Force (USPSTF) released its latest findings last year regarding osteoporosis, fall risk and recommended actions for physicians. They concluded:

  • Exercise (3+ times per week), including resistance training, was the most consistently effective intervention to reduce falls amongst older adults.

  • Supplementation: reversing previous advice, a draft recommendation suggests there is no strong evidence that supplementing vitamin D or calcium has a consistently beneficial impact on falls in older adults. Your doctor may, however, recommend vitamin D or calcium for maintaining bone health.

Additional research published recently also found the following interventions to be positive for both fall risk and osteoporosis.

  • Plyometric Exercise: an analysis of several studies that looked at healthy older adults (aged 60-75) who enrolled in plyometric exercises like jumping and hopping, determined that measures of bone density, muscle strength and balance were improved compared to controls. They also report that such supervised interventions were shown to be safe for this population, though the authors note further research is necessary to understand if plyometric exercise is appropriate for adults over 75 or those managing chronic disease or comorbidities.

  • Diet: overweight women who followed a Mediterranean diet and completed an exercise program of 45 minutes walking daily and 2 strength sessions per week, lost weight and improved bone density compared to a control group. This is significant because often weight loss is accompanied by bone loss and this study improved bone density in participants. The study followed nearly 1,000 women over 3 years.

What You Can Do

Like any goal setting, it’s important to know where you are now in terms of your personal fall risk and risk for osteoporosis. The best way to do this is to speak with your doctor and ask for an objective measurement of both fall risk and osteoporosis risk. This might be a bone density scan to detect how strong your bones are, and a balance test like the Zibrio Stability scale to measure your risk of falling.

Before your appointment, you can help your doctor and yourself by gathering information about any previous falls or fractures you may have had, and also any family history of fractures or known osteoporosis or osteopenia. This history can give a general idea of if you are at high risk, but bear in mind that, on its own, it is not the most accurate way to judge your current risk.

Your doctor may ask you about lifestyle factors such as how much exercise you do, and whether you drink alcohol or smoke regularly. Certain medications can also have a negative impact on both fall risk and osteoporosis.

If you have osteoporosis or osteopenia, your doctor may prescribe you medication to help slow bone loss. There are other lifestyle changes you can make to support this, particularly weight bearing exercise.

Be ready to make small changes to improve both your fall risk and your risk of osteoporosis. Whether you discover you are at high risk today or simply want to prevent yourself from becoming high risk, making positive changes now can make a real difference.

These changes might be starting to do weight bearing exercise regularly (twice a week is recommended), starting an exercise class, spending more time outside adding some foods which are high in calcium to your meal planning. The key is to pick one or two things you could easily change this week and do them. Consistency is more important than volume, so make it as easy as possible for yourself.

The good news is that choices like following a healthy diet, maintaining a healthy weight and taking regular exercise are good for balance, bone health, and your general health too (these are the same guidelines for managing cardiovascular health, brain health, and metabolic health).

Implementing Your Plan

We are often asked what is the best exercise for balance. The truth is that the best exercise is one that you will do regularly, ideally daily. If you don’t currently walk, start there. Always discuss this with your doctor, so that they can advise you what exercise is appropriate for you — will challenge you enough while not putting you in danger of falling! You may start with a course of physical therapy and then progress to other exercise. Remember that to help both your balance and your bones, it’s important to include weight bearing exercise.

Think about types of exercise you might enjoy, and be willing to try something new. Do you prefer exercising alone or in a group? Inside or outside? With a trainer or following videos in the privacy of your home? There are so many options, and many of them may not cost you anything.

Monitor Your Progress: it’s hard to keep doing something if you don’t know for sure that it’s working. Many gyms and community centers can help you test your strength and mobility, some even have ways to measure your balance and fall risk, like the Zibrio Stability scale. Your doctor will need to measure your bone density again on a regular basis. Write down your results so that you can compare your measurements as you make progress. And celebrate your wins along the way!

Preventing Falls

If you have osteoporosis, it’s important to do all you can to prevent having a fall, as even a low impact fall could result in broken bones. A fall occurs when your body’s ability to maintain your postural control is weaker than the environmental challenges around you. Some people with poor balance can fall easily, whereas people with good balance require a greater hazard, such as a slippery surface, or something knocking into them, to cause a fall.

No matter where your balance is today, or how old you are, you can improve it. Working on leg strength, flexibility and joint mobility is a good start. So is doing exercises that use your feet. While you are building up your balance, take the time to look around your environment and see what you can do to make it safer:

  • Remove clutter or trailing cords

  • Make sure rugs are secure and won’t trip you up

  • Consider night lights or smart lights for when it’s dark on stairs and in the bedroom and bathroom

  • Consider installing grab bars in the bathroom, where surfaces are often slippery

  • Make sure stairs have sturdy railings and garden paths are safe and well marked

Fear

Many people are afraid to find out about their fall risk or osteoporosis risk, and while that may be natural, the sooner you know where you are, the sooner you can take action to protect yourself and even improve the state of your bones and your balance. A fear of falling often makes people do less, which makes them more likely to fall. Similarly, some people just don’t want to know about the state of their bones, falsely believing that nothing can be done.

Accurate measurement can help you see clearly where you need help, and gives you a baseline against which you can measure your progress.

Fun fact: Independent Living residents reduced their falls by 74% when they regularly measured their balance using Zibrio technology. You can read the published research here.

Zibrio is committed to saving the world from falling down. While we start with measurement, there is so much more you get with our technology packages. Learn about our solutions:

Balance & Agingzibriobone health, balance