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Women can expect to lose around one per cent of their bone mineral density each year after their menopause. This means that they are likely to develop osteoporosis into old age.

Older women need to consider discussing with their doctor 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, have sufficient vitamin D levels and stay 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. Physical activity will lead to improvements in posture, 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 negative calcium balance. The body compensates by drawing calcium out of your bones if your dietary intake is insufficient. After menopause women, need to have about 1000 mg of calcium daily – Equivalent to 3-4 serves of dairy products per day. If you find this intake difficult to achieve, it may be necessary to take calcium supplements.

Vitamin D

Vitamin D has actions through the gut, bone and kidney to help maintain adequate body calcium. As we get older maintaining adequate levels of vitamin D may help in improving muscle strength and reducing falls. Some people will find it difficult to achieve normal levels of vitamin D through sunlight exposure (15 minutes per day is recommended) and may require vitamin D supplements. Your doctor can easily measure your level of vitamin D through a simple blood test.

Avoid smoking

Smoking is an important risk factor for osteoporosis. It is never too late to stop smoking in terms of improving bone health.

Fall prevention

The increased risk of falling, in addition to the decline in bone density with ageing, places the elderly population at risk of fractures. An older person is often less able to correct postural imbalance, so may fall in an awkward manner, which increases the likelihood of fracture. Frequent falls can also lead to a loss of confidence and reduced mobility in the elderly. Devices such as hip protectors can reduce the likelihood of hip fractures after falling.

Ways in which elderly people can minimise their risk of falls include:

• Ensuring there is adequate lighting within the home (and turn on lights 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)
• Reviewing medications, which may affect balance; e.g. antihypertensives, sedatives (sleeping tablets), narcotics (sedating pain killers)
• Regular vision checks
• Wearing footwear that provides support for the feet and adequate traction when walking
• Removing rugs
• Installing rails in the shower toilet and hallways
• Placing non-slip mats in the bathroom
• Using walking aides when needed, e.g. walking frames and walking sticks
• Exercise to improve balance and strengthen muscles (a physiotherapist can prescribe an appropriate program)

It may be beneficial for some to see a physiotherapist or occupational therapist.. Physiotherapists can provide advice on muscle strengthening exercises and provide aides for walking. Occupational therapists help make the home environment safer, for instance by installing rails.

These and many other measures can help reduce the risk of falls within the home. To obtain such services, it is recommended that you see your doctor or contact a community health centre.

Further resources

Content updated 3 August 2011