Older Women, Hip Fractures and Bone Tests

When older women fracture a hip, they usually don’t get a bone density test that shows whether they need treatment to help prevent more broken bones. According to a new study, just 17 percent of women get tested for osteoporosis or receive treatment for the condition. This is unfortunate, since osteoporosis screening helps identify women at risk for future fractures.

All older women (especially those with a recent hip fracture) should be screened for osteoporosis. This allows:

• Health providers to assess a woman’s bone strength.
• A baseline to be established for possible drug or other treatments.
• The comparison of results over time to determine how the therapy is working.

Bone-Strengthening Strategies

Calcium

• Women should consume at least 1,000 mg of calcium per day. The main dietary sources of calcium include milk and other dairy products, such as cottage cheese, yogurt and hard cheese; and green vegetables, such as kale and broccoli.
• Calcium supplements (calcium carbonate or calcium citrate) are suggested for women who cannot get enough calcium in their diet.

Vitamin D

• It’s recommend that postmenopausal women consume 800 international units of vitamin D each day. This dose helps reduce bone loss and fracture risk in older women who have adequate calcium intake.
• Milk with vitamin D is a primary dietary source of vitamin D. Another good source is salmon, with approximately 600 international units for each 3.5 oz. serving.
• Vitamin D supplementation is generally recommended for all persons with osteoporosis whose intake of vitamin D is below 600 international units per day.

Osteoporosis Drugs

• A medication may be recommended for certain women who have or who are at risk for osteoporosis. These include postmenopausal women with a history of hip or vertebral fracture or with established osteoporosis (bone tests showing decreased bone strength). The final decision about use of a medication should be discussed between the woman and her doctor.

Lastly, most hip fractures are due to falling. Thus, efforts to prevent falls also can help avoid future fractures. Preventive strategies include the following:

• Exercising to decrease fracture risk by improving bone strength and helping to increase muscle strength, which improves balance.
• Home modifications to make day-to-day life safer to navigate (such as removing loose rugs or other tripping hazards), and providing adequate lighting in all areas inside the home, including stairwells and entranceways.
• Reviewing drug regimens to replace medications that may increase the risk of falls with those that are less likely to do so.