By Ronald DiSimone, MD
As we age, so do our bones. Our bones begin to lose mass or density as we get older. They start to lose calcium and other minerals, which can make them more brittle and fragile.
Bone changes can put us at risk for conditions like osteoporosis. They also can put us at higher risk of bone fractures and other physical changes to our bodies.
It is possible to help prevent, delay, or manage age-related bone changes. Here’s what happens to bones as we get older and what you can do to keep you bones healthy.
What Are Bones Made of?
A protein called collagen makes up most of our bones, providing their framework. The mineral calcium phosphate hardens bones and makes them strong.
Together, the collagen and calcium make the bones strong and flexible enough to do everything they do — and that’s a lot. They support our bodies, make it possible for us to move, protect important organs, store minerals, and much more. Our bones are critical to helping us survive and perform virtually every task.
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What Happens When Bones Age?
Bones are living tissue. We are constantly losing and replacing bone tissue.
When we’re younger, we replace more bone tissue than we lose. As a result, our bones become denser, larger, and heavier. Our bone mass usually peaks in our 20s.
As we get older, the balance between losing and replacing bone begins to shift in the other direction. We begin to lose more bone tissue than we replace.
Bone loss usually starts slowly but gets faster as we reach middle age. Women typically begin to experience more rapid bone loss after menopause, which usually begins around ages 45 to 55. Bone loss in men happens more gradually, but by age 65, women and men lose bone mass at about the same rate.
What Is Osteoporosis?
Osteoporosis is a bone disease. It can develop when our bones lose mass and density, causing them to become thinner, more brittle, and more fragile. According to estimates, more than 10 million people in the United States have osteoporosis.
People with osteoporosis have a higher risk of bone fractures. They can occur after major or minor falls or even after doing things like bending or lifting. Hip fractures due to osteoporosis are a leading cause of disability, loss of independence, and death in older Americans.
Even the most routine activities can cause major health risks when someone has arthritis. Simple tasks, such as twisting your wrist or back to pivot a vacuum, or even stepping off of a curb, could lead to a fracture or potentially even the need for a joint replacement down the road depending on the severity of the injury.
Not all fractures related to osteoporosis occur within the knee and hip. Wrist and spinal fractures also are common osteoporosis-related fractures. Spinal fractures can cause older adults to lose height or develop a “dowager’s hump” in the back.
Osteoporosis is a silent disease for many people because they don’t feel symptoms until they suffer a fracture. Women should get screened for osteoporosis beginning at age 65, or earlier if they’re at higher risk for fractures. Men should talk to their doctors about when to get screened for osteoporosis.
Preventing and Managing Bone Loss
There are ways you can slow the age-related impacts on your bones and possibly prevent osteoporosis.
- Eating a healthy diet, especially one that includes high amounts of vitamin D and calcium.
- Exercising regularly.
- Avoiding smoking or stopping smoking.
- Drinking alcohol only in moderation.
- Taking medications or vitamin supplements as needed to support a healthy musculoskeletal system.
If you have osteoporosis, you can manage the disease in many different ways, including:
- Exercising. An exercise program that includes balance and resistance/weight-bearing work can help you lower your risk of falls.
- Eating a healthy diet. Try to incorporate needed amounts of vitamin D, calcium, protein, fruits, and vegetables.
- Assessing your environment. Try to make your home as fall-proof as possible.
- Avoiding or quitting smoking. Self-explanatory! Also, try to limit your exposure to secondhand smoke.
- Avoiding heavy alcohol consumption. Not only is alcohol bad for your bone health, drinking heavily can make falls more likely.
- Taking medications. Doctors may prescribe many different medications for managing osteoporosis. The most common include bisphosphonates, denosumab, teriparatide, abaloparatide, selective estrogen receptor modulators (SERMS), and more. Over-the-counter medications also are available that may be commonly associated with managing osteoporosis, including OsCal with vitamin D3.
- Spending time in the sun. Getting 40 minutes of sunlight a day can boost your vitamin D levels.
Aging is a normal part of life — and as you age, so will your bones, joints, and muscles. But while aging can affect your bones, you still can take steps to stay healthy and protect yourself.
The UPMC Department of Orthopaedics provides expert care for conditions of the bones, joints, and muscles. To find a provider near you, visit our website.
Ronald DiSimone, MD, is an orthopaedic surgeon for UPMC in North Central Pa.
A.L. Boskey and R. Coleman, Journal of Dental Research, Aging and Bone. Link
American Academy of Orthopaedic Surgeons, Effects of Aging. Link
American Family Physician, Diagnosis and Management of Osteoporosis. Link
National Institute of Arthritis and Musculoskeletal and Skin Diseases, What Is Bone? Link
National Institute of Arthritis and Musculoskeletal and Skin Diseases, Osteoporosis Overview. Link
National Library of Medicine, Aging Changes in the Bones — Muscles — Joints. Link
About UPMC Orthopaedic Care
When you are dealing with bone, muscle, or joint pain, it can affect your daily life. UPMC Orthopaedic Care can help. As a national leader in advanced orthopaedic care, we diagnose and treat a full range of musculoskeletal disorders, from the acute and chronic to the common and complex. We provide access to UPMC’s vast network of support services for both surgical and nonsurgical treatments and a full continuum of care. Our multidisciplinary team of experts will work with you to develop the treatment plan that works best for you. Our care team uses the most innovative tools and techniques to provide better outcomes. We also are leaders in research and clinical trials, striving to find better ways to provide our patients care. With locations throughout our communities, you can find a provider near you.