APTA Michigan Lines Blog Details

Osteoporosis in older adults and its relationship with falls/fractures

Every second of every day, an older adult (65+) sustains a fall in the United States. In addition, falls are the leading cause of injury in this age group.¹ Osteoporosis is a condition that causes bones to become brittle, which may increase the risk of a fracture. Typically, older adults have various impairments such as vestibular disorders, vitamin D insufficiency, medications, postural hypotension, vision impairment, foot/ankle pathology, and trip hazards that increase the likelihood of falls.² This can be extremely problematic for older adults who have osteoporosis. The best intervention for falls is prevention. By routinely screening elderly patients and taking preventative measures, falls and secondary complications can be prevented as a whole.

The prevalence of osteoporosis is a worldwide problem.5 Patients within the elderly population are more prone to having a reduction in bone density. Unfortunately, osteoporosis is on the rise within many countries. Researchers attribute this increase to elderly people living longer than before.5 It has been determined that a primary cause of bone density loss is through immobilization. When a patient is immobilized in a bed, they can lose just as much bone in a week as they would otherwise lose within a year.5 A way to prevent this bone density loss is to continuously emphasize the importance of strengthening exercises.

Individualized fall prevention programs have been found to reduce fall risk factors in older adults.³ One individualized program aimed at reducing difficulties in ADLs, improving self-efficacy, and reducing fear of falling in adults over the age of 70, and the program yielded positive results. Treatments were conducted by an occupational therapist to identify home trip hazards and provide environmental modifications. In addition, a visit by a physical therapist focused on balance, muscle strengthening, and fall recovery techniques. The results found that participants in the intervention group had improved ADL’s, self-efficacy, and a decreased fear of falling. ⁴

There are ways for osteoporosis to be avoided. Levels of osteoporosis prevention have been established as primary, secondary, and tertiary. Primary prevention techniques are meant to maintain bone density and minimize bone loss in the early adult years.5 While genetic factors can help to predict a patient’s bone loss, lifestyle changes can help to prolong having high bone density. Exercising and increasing the amount of calcium in a diet can be beneficial for maintaining bone density in elderly patients. Secondary prevention techniques focus on patients who have osteoporosis or osteopenia.5 This particular approach is emphasized for post-menopausal women and the elderly. Lastly, there is tertiary prevention. This type of bone loss prevention involves patients who have had previous bone fractures.5

            The rise of osteoporosis has increasingly become a worldwide problem that must be addressed. As patients are living longer, the need for lifestyle changes and promoting strengthening exercises has become evident. When a patient falls with osteoporosis, their impairments can be traumatic. There are a multitude of factors that can contribute to a patient falling, and thus giving patients the proper education needed for fall prevention can be crucial for their overall wellbeing.2 Various fall prevention programs have been created to help reduce falls, and these have been shown to be effective. The best intervention for falling is prevention education, and many lives will be saved around the world if health care professionals advocate for this.

Works Cited

  1. “Keep on Your Feet-Preventing Older Adult Falls.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 16 Dec. 2020, www.cdc.gov/injury/features/older-adult-falls/index.html.
  2. FACT SHEET Risk Factors for Falls, CDC, 2017, www.cdc.gov/steadi/pdf/STEADI-FactSheet-RiskFactors-508.pdf.
  3. Lord, Stephen R., et al. “The Effect of an Individualized Fall Prevention Program on Fall Risk and Falls in Older People: A Randomized, Controlled Trial.” American Geriatrics Society, John Wiley & Sons, Ltd, 14 June 2005, agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/j.1532-5415.2005.53425.x?casa_token=Z4pmioYntpcAAAAA%3AwwIgeJOIaBgHj4x6-Ex1MXU53SPG34NGYP4rCSsPgvFOBKQPQNXc8qViH8QVY8Cr7JwjPczaBsJzpKo.
  4. Chase, Carla, et al. Systematic Review of the Effect of Home Modification and Fall Prevention Programs on Falls and the Performance of Community-Dwelling Older Adults, www.researchgate.net/profile/Carla-Chase/publication/224878781_Systematic_Review_of_the_Effect_of_Home_Modification_and_Fall_Prevention_Programs_on_Falls_and_the_Performance_of_Community-Dwelling_Older_Adults/links/55cb78c908aebc967dfe174a/Systematic-Review-of-the-Effect-of-Home-Modification-and-Fall-Prevention-Programs-on-Falls-and-the-Performance-of-Community-Dwelling-Older-Adults.pdf.
  5. Posa G, Roka E, Sziver E, et al. Osteoporosis and the Role of Physical Therapy in the Different Domains. Journal of Osteoporosis and Physical Activity. 2017;05(01). doi:10.4172/2329-9509.1000190


Please to add your comments.