How does my risk of osteoporosis increase as I age?

Audrey K. Chun, MD
Geriatric Medicine
Healthy bones are in a state of continuous breakdown and rebuilding. This process is called remodeling and is performed by specialized cells called osteoclasts, which resorb (break down) old bone, and osteoblasts, which form new bone. In young adults, remodeling happens in a balanced fashion that maintains bone density over time. But as we age, and particularly when women reach menopause and estrogen levels plummet, the process is no longer balanced -- more bone is broken down, and bone building is unable to keep up. The result is reduced bone mineral density (BMD), an increased risk of osteoporosis, and brittle bones that are prone to fracture.
David Slovik, MD
Endocrinology Diabetes & Metabolism
Time alone increases the risk for osteoporosis. The researchers in the Study of Osteoporotic Fractures noted that, on average, bone mass fell by approximately 5% every five years after age 65. The risk for a fracture also increases with age. For example, among white women under age 35 there are just two hip fractures per 100,000, but that number soars to 3,000 hip fractures per 100,000 at age 85 or older.
An average adult will have bones the strongest around the mid 30s. After this, advanced age, decreased hormones and lack of exercise all lead to an increased chance of osteoporosis.

As we age our bones are constantly being built up and broken down at the cellular level. However, with advanced age, there is more bone breakdown than formation, making bones weaker with age.

Women are more prone to osteoporosis because of the sudden decrease in estrogen at menopause.

Exercise, specifically weight-bearing exercise, can help to keep bones stronger, but as we age, we lose 10-20% of our muscle strength/power per decade past 50. People who do not exercise are at greater risk for osteoporosis.
As a normal part of aging, your risk of osteoporosis has increased because you've been losing some bone mass for decades now -- especially in the years immediately after menopause. By your 60s this rate may have started to slow, but you still could be at significant risk. The good news is that calcium, exercise, vitamins and medications can help strengthen your bones at any age.

If you haven't had a bone density scan, you should have one by the time you are 65 to assess your risk for osteoporosis, which can lead to fractures. If you are under age 65 but have suffered a fracture or have other risk factors of osteoporosis, you should have a bone density scan as soon as possible. 

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