Bone health and preventing falls

Bone loss is silent. Osteoporosis usually causes no symptoms at all until a bone breaks, which is why the first sign is often a fracture from a fall that should not have caused one. Falls are the leading cause of injury-related hospitalisation among older adults in Canada, and the consequences reach well beyond the bone itself — a hip fracture frequently marks a permanent loss of independence.

The encouraging part is that both halves of the problem respond to the same kind of effort.

Keeping bone strong

• Weight-bearing and resistance exercise. Bone responds to load. Walking, stair climbing, and above all strength training two or more times a week.
• Enough calcium, preferably from food. Dairy, fortified plant drinks, canned fish with bones, tofu set with calcium, and leafy greens.
• Vitamin D. Hard to get from sunlight in a Canadian winter at our latitude. Health Canada recommends a daily supplement for adults over 50, and many people benefit year-round.
• Not smoking, and limiting alcohol. Both reduce bone density directly.

Bone density testing is recommended for everyone over 65, and earlier for people with risk factors — a previous fracture after age 40, long-term steroid use, rheumatoid arthritis, early menopause, or a parent who fractured a hip.

Preventing the fall itself

Strong bones help, but not falling helps more. The most effective single intervention is balance and strength training — and the evidence is strongest for programmes that genuinely challenge balance rather than gentle movement alone. A physiotherapist can assess your balance and build a programme at the right level, which is safer and more effective than guessing.

Beyond exercise:

• Review your medications once a year with a pharmacist or doctor. Sedatives, blood-pressure medication and anything causing drowsiness raise fall risk, and people often accumulate them over the years.
• Get your eyes checked. Poor vision and falls are closely linked. Be careful with new bifocals or progressives on stairs.
• Deal with the house. Loose rugs, poor lighting on stairs, no grab bar in the bathroom, clutter on the floor.
• Wear proper footwear indoors. Socks on hardwood cause a surprising number of falls.

After a fall

Tell someone even if nothing broke. One fall substantially raises the chance of another, and it is the point at which an assessment does the most good. If there is any chance of a hip, wrist or head injury — or you take blood thinners — be seen the same day.

Sources

• Osteoporosis Canada — Exercise and bone health
• Public Health Agency of Canada — Seniors and falls
• Canadian Society for Exercise Physiology — 24-Hour Movement Guidelines
• Health Canada — Vitamin D