Nursing Home Patients With Osteopenia May Suffer More Severe Injuries During Falls

Picture-314Bone health is a serious concern for older adults. As you age, your bones get weaker as they lose their internal support structures. Older, weaker bones are more susceptible to serious bone breaks (fractures) because they have lower levels of important minerals including calcium and phosphorous. 

Osteopenia is a lower than normal peak bone mineral density (BMD). While not as severe as osteoporosis, it does increase your risk for osteoporosis. Bone mineral density is an indicator for how strong and healthy your bones are. BMD peaks in your late 20s to early 30s, after which it starts to decline. If your BMD is between 1.0 and 2.49 standard deviations below the average peak BMD, you suffer from ostenpenia. 

Women have a lower peak BMD than men and menopause causes hormone changes that speed up the loss of bone mass, which increases their risk of developing osteoporosis and osteopenia. In the United States, about 30% of Caucasian postmenopausal women in the United States have osteoporosis, and 54% have osteopenia.

For older adults, proper bone health is not just a matter of maintaining overall health; proper bone health can also affect mobility and independence. It is never too late to take steps to improve or maintain good bone health in order to prevent dangerous fractures. These lifestyle changes include:

  • Receiving proper levels of calcium in your diet (maybe including a calcium supplement combined with vitamin D)
  • Not using tobacco products (they can weaken bones)
  • Not consuming excessive amounts of alcohol
  • Exercising and remaining active (bone forms in response to stress, so weight-bearing exercises are good choices)
  • Taking caution to avoid dangerous bone breaks
  • Getting early treatment for eating disorders (low body weight can increase the risk of hip fracture)

Osteopenia does not have any symptoms, but doctors can diagnose low BMD with a bone density scan. This can help you and your doctor decide if bone strengthening drugs are an appropriate treatment option. Many women who have menopause also have osteopenia. 

Some doctors recommend osteoporosis medicine including Fosamax, Boniva, or hormone therapy right away to prevent further bone loss. However, as with any medication, these drugs have side effects and associated risks. Other doctors recommend that you exercise and take calcium. And, some researchers caution that many younger postmenopausal women are taking drugs that they don’t need because osteopenia is just a risk marker for osteoporosis. 

The World Health Organization developed a tool that helps predict a person’s overall risk of major fracture over the next 10 years by factoring in a variety of risk factors including: age, bone mineral density test results, family history of osteoporosis, use of oral steroids, whether or not you have rheumatoid arthritis, and whether or not you smoke. And, the National Osteoporosis Foundation revised its treatment guidelines as follows: drugs should be considered for postmenopausal women and men age 50 and older who have a 10-year probability of a major osteoporosis-related fracture ≥ 20% or a 10-year probability of hip fracture of ≥ 3%. 

If you or a family member is a nursing home resident it is important to ensure that you are receiving adequate calcium in your diet and proper activity and exercise to promote bone formation. Also, if you have risk factors for osteoporosis, you should have a bone mineral density test performed in order to determine your chances of developing osteoporosis and suffering dangerous bone breaks. Your bones are an important factor in maintaining independence and mobility, and nursing homes should ensure that you maintain proper bone health. If you are worried that a family member not receiving proper nutrition or BMD testing, it is important to talk with the nursing home staff as soon as possible to address the problem. 


WebMD: Osteoporosis Health Center – Osteopenia

University of Washington: Department of Radiology – Osteopenia

U.S. News: Health – Grappling with a diagnosis of Osteopenia
Pub Med: Vitamin K deficiency and osteopenia in elderly women with Alzheimer’s disease

JAMA: Osteopenia and Preventing Fractures

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