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Why do we fall over when we get older?

As the world's population lives longer, the significance of osteoporosis and fractures increases.

In Australia, it is estimated that 4.74 million Australians aged over 50 have osteoporosis, osteopenia (less severe than osteoporosis) or poor bone health. By 2022, it's estimated this will increase to 6.2 million, with one fracture occuring every 2.9 minutes. 

There are many reasons older adults are susceptible to falls. These include impairments and less ability to prevent tripping over as balance, muscle mass and strength decline with age.

The risk of fracture due to poor bones increases with age, and this is further enhanced by osteoporosis.

Genetics also plays a role in an individual's risk of fracture. Those of us with parents who had a hip fracture have an increased risk of fracture. The most common sites of fracture in older adults are the hip, vertebrae or spine, wrist or the humerus (upper arm or shoulder). 

About 30% of older adults fall at least once a year. The less often you fall, the less likely you are to break a bone. 

People aged 70 and over accounted for 70% of the total acute hospital inpatient costs in 2012. Hip fractures impose the highest burden in terms of both cost and decline in health-related quality of life. 

Results from a recent study show most fracture patients have not fully recovered their previous level of quality of life by 18 months after the fracture.

Preventing osteoporosis & falls

Preventing falls in older people is an important way to prevent fractures. Adults who have good balance and muscle strength are often able to "save themselves" when they trip. Exercises that improve balance (such as Tai Chi) and help maintain muscle mass (weight-bearing and resistance exercises) are beneficial. 

Preventing osteoporosis involves regular weight bearing and resistance exercise, adequate calcium in the diet (at least three serves of dairy or equivalent per day) and an adequate level of vitamin D in the bloodstream. 

Sunlight exposure on the skin is the primary source of vitamin D, but we need to practise safe sun exposure to reduce the risk of skin cancer. The recommendations vary by skin type, latitude and season. For people with moderately fair skin, six to seven minutes before 11am or after 3pmduring summertime is considered sufficient. 

During wintertime, the daily recommended sun exposure increases to between seven and 40 minutes depending on where you live in Australia.

While lifestyle factors such as nutrition and exercise can make an important difference to bone health over time, if an older adult has several risk factors for fracture their doctor may discuss the benefits of "bone active" medication. These medications slow the rate bone breaks down as we age.

In general, these medications halve the risk of fracture and are much more effective than lifestyle measures alone. 

Reference: Sanders, Prof. Kerrie. "why Older People Get Osteoporosis and Have Falls". The Conversation. N.p., 2017. Web. 13 Feb. 2017. Viewed at https://theconversation.com/why-older-people-get-osteoporosis-and-have-falls-68145

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