Improving bone strength by just 3% slashes hip fracture rate by 45%

According to the Centers for Disease Control and Prevention (CDC), more than 300,000 Americans aged 65 and older are hospitalized for hip fractures each year. The major health issues come in the wake of the break. One in three adults over the age of 50 who fracture their hip will die within 12 months. The injury comes with an increased risk of post-surgical complications such as stroke, infection, heart disease and pneumonia.

Slow recovery also contributes to a loss of muscle mass, increasing risk of another fall – the source of around 95% of hip fractures. And many who do recover lose their independence and suffer chronic pain and mobility issues.

While the loss of bone density is inevitable with aging, a new study has shown that just small changes to improve skeletal health can have a huge impact on the prevalence of hip fractures. University of Technology Sydney (UTS) researchers, led by professor Tuan Nguyen, have collected quantifiable data showing that simple measures can greatly improve bone health, even if those small steps feel insignificant.

“Some people who are following medication regimens or engaging in lifestyle modification programs and notice a slight change in bone mineral density might believe that these measures hold little benefit for them,” said Nguyen. “Nonetheless, even these minor effects can lead to a substantial reduction in fracture risk for the community.”

Drawing from data gathered in the Dubbo Osteoporosis Epidemiology Study (DOES), the researchers looked at two cohorts aged 60 and over who had been assessed for fracture incidence and risk factors over different periods of time – 1,311 women and 842 men in 1989-1992, and 974 women and 544 men in 1999-2001.

They found that in the second cohort, there was an average bone density increase of 3%. With this came a 45% decrease in the number of hip fractures within the population. This sort of drop has more often been attributed to an improvement of around 10% in bone density. As such, it’s an encouraging result that suggests minor improvements can have a significant health result across an aging population.

“Our study suggests that population strategies focused on reducing risk in those at low or moderate risk are likely to be more effective than strategies just focused on high-risk individuals,” he said.

High-risk individuals are those with osteoporosis. While around 20% of women aged 50 and over and 5% of men in the same demographic have this disease, marked by an advanced loss of bone density, they don’t account for most hip fractures.

“Osteoporotic individuals have the highest risk of a hip fracture, and pharmacologic treatment can reduce this risk by around 50%,” said Nguyen. “However, the majority of hip fractures occur in people who do not have osteoporosis, so it is important for everyone, especially the elderly, to take action to improve their bone health. Bone mineral density is modifiable, and even small improvements reduce the risk of a fracture.”

The researchers suggest that 3% improvement can come through moderate lifestyle changes, such as light exercise, quitting smoking and increasing vitamin and mineral intake.

Exercise not only builds bone strength, but improves balance and coordination, lowering the risk of falls. It’s also increasingly linked to improved cognitive function.

“Bone health is affected by lifestyle factors such as smoking, physical activity and nutrition, including vitamin D and dietary calcium intake,” said Nguyen. “Stopping smoking, maintaining moderate physical activity, and eating a healthy diet can all help reduce bone loss.”

The study was published in the Journal of Bone and Mineral Research.

Source: University of Technology Sydney

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