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Women can expect to lose around 1% of their bone mineral density each year in the years beyond their menopause. This means that you are likely to develop osteoporosis into old age.
Older women need to consider having discussions with their doctor to find out ways to improve their bone health and whether they need specific investigations for osteoporosis.
Women in this age group may be on specific treatments for osteoporosis. Even in this setting women need to ensure they have adequate calcium in their diet, sufficient vitamin D levels and being active so they gain the maximal effect from their osteoporosis treatment.
Bone Production
Bone is living tissue made up of specialised bone cells and, like the rest of the body, it is constantly being broken down and renewed. Sustaining bone density and strength requires a lifelong intake of calcium, healthy eating with adequate vitamin D and an active life.
Maintaining healthy bones
Physical Activity
No matter what your age, bone needs physical activity, just like muscle, to retain strength. It is important to discuss exercise options with your doctor to ensure it is safe to take part in a physical activity program.
It is also important to consider seeing a physiotherapist who can provide assistance with specific types of activities, which will address issues of improving posture and balance, coordination and muscle strength.
Calcium
Following menopause, lower oestrogen levels impact on your body's ability to maintain the calcium levels in your bones.
Right at the time when you need to increase your intake of calcium, the gastrointestinal system becomes less efficient at absorbing calcium from food. The kidney also becomes less efficient in conserving calcium creating a state of potential calcium loss in the blood. The body compensates by drawing calcium out of your bones.
So, not only do the bones become weaker because of oestrogen deficiency at menopause, they also lose more calcium. The way to reduce the loss of calcium from the bones and compensate for less absorption is to increase the intake of calcium through your foods. After menopause women need to have about 1000mg of calcium per day- the equivalent to 3-4 serves of dairy products/day. If you find this intake difficult to achieve, it may be necessary to take calcium supplements.
Vitamin D
Women also need adequate levels of Vitamin D which assists in the deposition of calcium in bone. The main source of vitamin D comes from exposing skin to the sun. Only 10-15 minutes of sunlight is needed daily to provide adequate levels of vitamin D. Some women may require vitamin D supplements. This is best done, after vitamin D levels have been measured by your doctor.
Avoid Smoking
Women who smoke, lose bone strength faster than women who do not smoke. To protect bones, it is advisable not to smoke.
Fall Prevention
Falls are a particular problem in the older woman as they can result in fractures particularly of the hip. Then there is the potential to develop a fear of falling again, with loss of confidence and mobility. Falls from a standing position are generally associated with a significant amount of force and in theory, anyone even individuals without osteoporosis could sustain a fracture. However, when osteoporosis is present, minor trauma such as coughing, minor knocks /falls can also lead to fractures.
Devices such as hip protectors are available which may also reduce the likelihood of hip fracture in the very frail older woman, who has a high risk of falls.
Ways in which the elderly can minimise their risk of falls include:
- Ensuring there is adequate lighting within the home/ Turn on light when getting up in the night
- Eliminating clutter within the home
- Rearranging furniture to avoid the risk of tripping over objects
- Eliminating the need for using stairs
- Medical check-ups if concerned about health (especially if there is a walking problem)
- Review of medications, which may affect balance eg. antihypertensives, sedatives (sleeping tablets), narcotics (sedating pain killers),
- Vision checks should be regularly conducted (to reduce the risk of falls due to poor eye sight)
- Wearing correct foot wear to provide support for the feet and adequate traction when walking
- Remove rugs
- Installing rails in the shower, toilet and hallways
- Place non-slip mats in the bathroom
- Use walking aids when needed eg. walking frames and walking sticks
- Exercise to improve balance and strengthen muscles (a physiotherapist can prescribe an appropriate program)
It may be necessary for the very frail elderly to see physiotherapists and/or occupational therapists. Physiotherapists provide assistance with provision of aides for walking. Occupational therapists make the home environment safe, for instance by installing rails.
These measures and many other measures can help reduce the risk of falls within the home. To obtain such services it is recommended that women see their local doctor or contact their community health centre.
Resources
Content updated December 22, 2006
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