Nancy Reagan, 87, was hospitalized this week for a broken pelvis and sacrum, the bone at the base of the spinal column, after a fall. Dr. Deborah Sellmeyer, director of the Johns Hopkins Metabolic Bone Center at Johns Hopkins Bayview Medical Center, spoke about bone fractures in older adults.
We tend to hear about hip fractures. How common is a pelvis fracture?
That’s a common one, too. People talk about hip in the broad sense of anything there at that joint.
Why do older adults suffer such fractures ?
As we age, we all lose bone, so we sort of get more and more fragile. Older folks also lose muscle mass and begin to have difficulty with balance and decreased vision and they may miss a stair or a curb. They might not have the coordination to get their hands out to break a fall.
What tends to be outcome of such a fracture?
Unfortunately about 25 percent of folks who have a hip fracture aren’t alive a year later. About a third end up requiring a nursing home when they were previously living on their own. It’s an incredibly debilitating thing to happen for an older person. It requires major surgery. They can get blood clots or pneumonia. That’s what tends to give us these poor outcomes.
How can you prevent them?
It would be best started in adolescence. We gain about half our bone in adolescence. It’s a critical time for growth and bones. Good calcium and vitamin D intake is important. We hit a peak bone mass in our late 20s and early 30s, and in our 50s we start to lose it again.
What should older people do?
Starting at any age does help. Be sure you are getting plenty of calories and good lean proteins and make sure you get enough calcium, which is about 1,200 to 1,500 mg a day. And vitamin D, [you should have] at least 1,000 mg a day.
Older men and women should have bone density testing for osteoporosis, which helps detect it before a fracture happens, and there is a variety of medication that can prevent fractures and bone loss.
