Bone Health Risk Assessment
Your Bone Health Risk Assessment
As we get older, our skeleton isn’t as indestructible as it once seemed. Understanding how age weakens the frame can help you keep moving freely and avoid painful breaks. Below you’ll find the key facts you need to protect your bone health and stay active for years to come.
Why Bones Change with Age
When you’re young, Bone is a living tissue that constantly renews itself through a balanced cycle of breakdown and rebuilding. This process, known as bone remodeling, relies on two main cell types: osteoclasts that dissolve old bone, and osteoblasts that lay down new bone. In your twenties, the balance tips toward formation, allowing you to reach peak bone mass.
After the third decade, the remodeling balance gradually shifts. Bone resorption starts to outpace formation, leading to a slow loss of density. Hormonal changes-especially the drop in estrogen during menopause-speed up this decline for many women. Men also experience a gradual dip in testosterone, which can affect bone upkeep.
Common Types of Age‑Related Bone Damage
Osteoporosis is a condition characterized by reduced bone mass and structural deterioration, making bones fragile and more likely to fracture. It often goes unnoticed until a fracture occurs, typically in the hip, spine, or wrist.
Another frequent complaint is Osteoarthritis a degenerative joint disease where cartilage breaks down, leading to pain and reduced mobility. While not a direct loss of bone density, the altered joint mechanics can increase stress on surrounding bone, contributing to micro‑damage.
Even in the absence of these diseases, normal age‑related bone loss (sometimes called senile osteoporosis) can still raise fracture risk, especially when combined with poor nutrition or a sedentary lifestyle.
Key Nutrients that Keep Bones Strong
Two nutrients dominate the conversation: Calcium is the primary mineral that forms the hard matrix of bone and Vitamin D facilitates calcium absorption in the gut and helps regulate bone remodeling hormones. The NZ Ministry of Health recommends 1000mg of calcium daily for adults and up to 1500mg for those over 70. Vitamin D needs rise to 800-1000IU daily for seniors, especially in regions with limited sunshine.
Food sources are plentiful: dairy, leafy greens, fortified plant milks, and oily fish provide calcium, while sunlight, eggs, and fortified cereals boost vitamin D. When diet falls short, supplements can fill the gap, but it’s wise to check blood levels first to avoid excessive dosing.
Lifestyle Moves that Preserve Bone Mass
Exercise isn’t just about cardio; it’s a powerful bone‑building stimulus. Weight‑bearing activity includes any movement that forces you to support your own weight, such as walking, jogging, dancing, or resistance training triggers osteoblasts to lay down new bone. Studies from the University of Otago (2023) show that seniors who perform 150 minutes of weight‑bearing exercise per week retain up to 2% more bone density than inactive peers.
Balance training-tai chi, yoga, or simple heel‑to‑toe walks-reduces fall risk, a critical factor since most fractures in older adults result from a fall. Strengthening the core and lower‑leg muscles also improves stability when navigating uneven surfaces.
How to Detect Bone Damage Early
The gold‑standard screening tool is the DEXA scan (dual‑energy X‑ray absorptiometry) that measures bone mineral density (BMD) at the hip and spine. Results are expressed as a T‑score: a score of -1.0 or above is normal, between -1.0 and -2.5 signals osteopenia, and -2.5 or lower confirms osteoporosis.
General practitioners often recommend a DEXA test for women over 65 and men over 70, or earlier if you have risk factors such as a family history of fractures, long‑term corticosteroid use, or low body weight. The scan takes about 10 minutes, involves minimal radiation, and can be covered by public health schemes in New Zealand.
Treatment Options When Bone Loss is Detected
Medication isn’t the only answer, but for moderate to severe osteoporosis, pharmacologic therapy can cut fracture risk by up to 50%. Common classes include:
- Bisphosphonates (e.g., alendronate) - inhibit osteoclast activity.
- Selective estrogen receptor modulators (SERMs) - mimic estrogen’s protective effect on bone.
- Monoclonal antibodies like denosumab - target the RANKL pathway to reduce bone resorption.
- Hormone replacement therapy (HRT) - useful for post‑menopausal women with severe symptoms, but requires careful cardiovascular assessment.
All medications should be paired with calcium (1200mg) and vitamin D (800-1000IU) supplementation, plus a regular exercise routine.
Practical Checklist for Maintaining Strong Bones
| Area | What to Do | Frequency / Target |
|---|---|---|
| Nutrition | Consume calcium‑rich foods and vitamin D sources | Daily: 1000‑1500mg Ca, 800‑1000IU D |
| Exercise | Weight‑bearing + resistance + balance training | 150min/week weight‑bearing, 2‑3sessions strength |
| Screening | Get a DEXA scan | Women≥65, Men≥70, or earlier with risk |
| Lifestyle | Avoid smoking, limit alcohol, maintain healthy weight | Ongoing |
| Medication (if prescribed) | Take as directed, monitor side‑effects | According to doctor’s schedule |
When to Seek Professional Help
If you notice any of the following, schedule a visit promptly:
- Sudden back pain or loss of height - could indicate a spinal fracture.
- Recurring joint pain not relieved by rest.
- Difficulty standing up from a chair or climbing stairs.
- Any fall that results in bruising, swelling, or inability to bear weight.
Early intervention can halt further bone loss and start the healing process.
Frequently Asked Questions
How often should I get a DEXA scan?
For most adults, a scan every 2-3 years is enough. If you’re on medication that affects bone density, your doctor may recommend annual testing.
Can men develop osteoporosis?
Yes. While less common than in women, men over 70 experience bone loss, especially if they have low testosterone, chronic steroid use, or a family history of fractures.
Is calcium supplement enough to prevent fractures?
Calcium alone helps maintain mineral content but doesn’t replace the mechanical stimulus that exercise provides. The best strategy mixes adequate calcium, vitamin D, and regular weight‑bearing activity.
What are the side effects of bisphosphonates?
Common issues include upset stomach, heartburn, or rare jaw osteonecrosis. Taking the pill with a full glass of water and staying upright for 30 minutes can reduce irritation.
Can I improve bone density after 70?
Absolutely. Studies show that consistent resistance training and proper nutrition can increase BMD by 1‑2% even in octogenarians, lowering fracture risk.