Preventing Secondary Fractures in Seniors

For men and women age 65 and older, a fracture of the hip or spine can be disabling and result in a lower quality of life.  And, seniors with fractures are highly likely to suffer another one within two years.

These serious health issues are often the first sign of osteoporosis, a condition that is responsible for more than two million fractures in the United States alone.

Some of these secondary fractures can be prevented with the proper diagnosis and treatment of osteoporosis.

People can also make some lifestyle changes to help strengthen their bones and reduce their risk of falling and secondary fractures.

Among hip fracture patients, one of every two never returns to their previous range of motion. One of every four is forced to move into a nursing home due to limited mobility, and one of every four dies within one year of the fracture, according to the American Society for Bone and Mineral Research. More than 40 leading medical organizations have joined efforts to effectively diagnose and treat osteoporosis.

“The goal is for patients and their families to understand the risk for falls and take action to prevent future fractures,” said Dr. Silvina Levis, an osteoporosis expert at the University of Miami Health System. “Once a senior person has suffered a fracture of the hip or spine, we focus on medication, physical activity, nutrition, and environmental changes to reduce their risk of falls and fractures.”

What can you do to reduce your risk of secondary fractures?

Working under the guidance of endocrinology or geriatric medicine healthcare providers, you should:

• Take medication, as prescribed, after an osteoporotic hip or spine fracture, regardless of bone density.
• Consult with your doctor about minimizing the use of medications associated with an increased fall risk. These include analgesics, opiates, antipsychotics, anticonvulsants, benzodiazepines, psychotropics, some antidepressants, and diuretics.
• Take plenty of vitamin D (800 IU or more) each day.
• Consume 1200 mg of calcium from food sources each day. Check with your healthcare provider before taking calcium supplements.
• Get evaluated and treated for conditions associated with an increased risk for falls (including impaired cognitive function, depression, arthritis, stroke, cataracts, urinary incontinence, and Parkinson’s disease).
• Visit a physiatrist (a physician specializing in physical medicine and rehabilitation).
• Go to physical and/or occupational therapy to improve your mobility, gait, and balance. And learn techniques to reduce the risk of falls during daily activities.

With the support of family, friends, and caretakers:

• Make diet and nutrition choices that support strong bones and muscles.
• Quit smoking.
• Exercise regularly (at least three times a week), including weight bearing, muscle strengthening, and low-impact balancing exercises (like tai chi and yoga).
• Make changes in your home environment to reduce the risk of tripping over rugs and clutter and bumping into furniture.
• Install a nightlight in the bedroom, bathroom or hallway to illuminate these areas at night.
• Reduce alcohol consumption to two drinks per day for men and one drink per day for women.
• Use a walker, cane, or wheelchair to provide support, if needed.
• Move into an assisted living facility for help with daily activities that pose a risk for falling, if needed.

As Dr. Levis points out, “It’s essential to receive regular medical evaluations by an endocrinologist or a primary care physician specializing in geriatric medicine to assess the risk of falling, evaluate the effectiveness of the treatment plan, monitor for adverse effects, and determine any necessary changes in treatment.”

Dana Kantrowitz is a contributing writer for UMiami Health News.

Tags: bone health, Dr. Silvina Levis, fractures, geriatrics, healthy aging, osteoporosis, secondary fractures, seniors