Brittle Bones and Broken Hips

Falling and fracturing a hip is one of the greatest fears many elders have, and for good reason. Hip fractures are associated with disability, nursing home placement and early death. Osteoporosis, a disease that makes bones weak and fragile, is thought to be a major contributor to hip fractures. Loss of bone strength is most common among older women, particularly whites and Asians.

For years, drugs known as bisphosphonates have been prescribed to strengthen bones and help prevent hip fractures in those people who are at risk of falling. However, according to a recent report in the British Medical Journal, medications designed to strengthen bones don’t offer much help in this effort.

The problem is that fractures are typically caused by falls, both in people with osteoporosis and in those with normal bone strength. Lots of people who don’t have osteoporosis fall and break bones anyway. Lots of people who do have osteoporosis don’t fall and never sustain fractures.

Moreover, bisphosphonates may be creating a false sense of security, sidetracking elders from taking proven fall-prevention measures to help avoid hip fracture, such as exercises to strengthen muscles and balance.

Elderly women who start exercising regularly may be able to reduce their risk of falls that result in broken bones or other serious injuries. The best workouts combine balance and strength training, completed at least three times a week. Activities that involve impact with the ground (such as jumping or hopping) are most effective in improving bone health.

Any decision on whether to start an exercise program or to stop (or continue) treatment with bisphosphonates should be based on an individual assessment of risks, benefits and preferences discussed between the elder and their doctor.

Rein Tideiksaar, Ph.D., PA-C, (or Dr. Rein as he is commonly referred to) is President of FallPrevent, LLC in Blackwood, New Jersey, a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr. Tideiksaar is a gerontologist (healthcare professional who specializes in working with elderly patients) and a geriatric physician's assistant. Check out Dr. Rein’s professional profile on LinkedIn:http://www.linkedin.com/pub/dr-rein/6/759/592. If you have any questions about preventing falls, please feel free to email Dr. Rein at [email protected].