One Fall, A Lifetime Impact: How to Prevent Hip Fractures in Older Adults (Part One)
By Orthopedic Surgeon James Slauterbeck, MD
Hip fractures are a serious problem for the elderly. Unfortunately, every year, more than 1.6 million adults worldwide suffer a hip fracture.
These injuries can change a person’s life quickly. About 15 percent of patients die within 6 months, and around 25 percent die within 1 year after a hip fracture. For those who survive, recovery can be very challenging. Only half regain basic daily function, and just about a quarter return to more complex activities. Many patients need to live long-term care facilities after hip fractures.
Hip fractures happen more often in women. About 75 percent of cases occur in women, who have twice the risk compared to men. This happens because women lose bone faster; they tend to live longer and often have smaller bones, which makes fractures more likely.
The good news is that some fracture risk can be lessened by improving balance and nutrition, preventing falls, avoiding certain medications and making good lifestyle choices can decrease risk. If possible, talk to your health care provider about avoiding certain medications like corticosteroids, levothyroxine, proton pump inhibitors, loop diuretics, antidepressants, benzodiazepines, and opioids. Consider making healthy lifestyle choices such as stopping smoking, avoiding drinking alcohol and consuming less than three cups of coffee per day.
Other ways to maximize your bone health starts with proper nutrition and screening. Patients at risk should have bone density testing using DXA. Calcium intake for most individuals should be 1,200 mg per day, and vitamin D should be 800 IU daily. Studies show that taking calcium and vitamin D together lowers the risk of hip fractures. Exercise is also one of the best ways to prevent fractures. Activities like walking, stair climbing, jogging, and dancing help maintain bone strength. Strength training increases bone density, especially when combined with weight-bearing activity. Some have suggested that whole body vibration therapy may also help improve bone strength and balance.
Fall prevention is critical. Balance training is very important because most hip fractures are caused by ground-level slips and falls. Exercise programs that combine strength, balance, and aerobic activity can reduce falls by nearly half. Tai chi is one of the most effective ways to prevent falls.
Some hip fractures can often be prevented with the right approach. Strong bones, good balance, proper nutrition, and regular exercise all play a role. In Part Two, we will look at how hip fractures are treated and how medications help prevent future fractures.
James Slauterbeck, MD, is an orthopedic surgeon whose special interests include sports medicine, adolescent sports medicine, female sports medicine, and high school and college athletic injuries. He is affiliated with UNC Health Orthopedics at Southeastern Health Park and UNC Health Southeastern. To learn more, call (910) 738-1065 or visit https://www.unchealth.org/care-services/doctors/s/james-r-slauterbeck-md.
