In older adults, hip fractures are usually caused by a
fall. Even a slight fall can sometimes cause a fracture in a weakened hipbone.
Children and young adults are more likely to break a hip because of a bike or
car accident or a sports injury.
Falls cause more
fractures—including hip fractures—as people age because, starting at about age
30, bone begins to be reabsorbed by the body faster than it is replaced. Over
time, it naturally gets thinner (less dense), weaker, and breaks more easily.
If bones thin a certain amount, you are said to have
osteoporosis. Both osteoporosis and hip fracture
affect women more often than men because men have higher bone density than
women and because of the decrease in the hormone
estrogen in women after
menopause. Having lower levels of estrogen speeds up
bone loss and results in weakened bones. Lower levels of testosterone in men
can also speed up bone loss.
Although men are also at risk for hip
fracture as they age, women have lower bone density to begin with, more bone
loss after middle age, and live longer than men. As a result, more than 75% of
all hip fractures occur in women.1
Some
medicines can also cause bone loss. These include
antacids that contain aluminum, and
corticosteroids used to treat conditions such as
asthma and chronic obstructive pulmonary disease
(COPD).
Studies have found that daily use
of medicines called SSRIs (selective serotonin reuptake inhibitors) may raise
the risk of bone fracture in adults over age 50. SSRIs are used for conditions
such as depression and anxiety. They are associated with bone loss and also
increase the risk of falling.2 Talk to your doctor
about this risk before taking an SSRI.
One study showed that
taking medicines called PPIs (proton pump inhibitors) for a long time,
especially in large doses, may raise the risk of hip fracture in adults over
age 50. PPIs decrease the amount of acid in the stomach. This reduces heartburn
and other symptoms of gastroesophageal reflux disease (GERD). PPIs are
also used to give
peptic ulcers time to heal.3
Talk to your doctor about this risk before taking a PPI.
Other
things that increase the risk for hip fracture include:
- Your family history (heredity). Being thin or
tall, or having family members who had fractures later in life increases your
risk.
- Race. White and Asian people have a higher risk of
osteoporosis; black people have a lower risk.
Osteoporosis raises the risk of a fracture if you fall, so the risk of hip
fracture is also higher in whites and Asians.
- Poor eating habits.
Not getting enough calcium and vitamin D can weaken bones.4 Studies show that calcium and vitamin D supplements will not
prevent fractures in people who already have risks of fracture such as low body
weight or previous fractures.5, 6 But getting enough calcium and vitamin D over your lifetime
will help you have stronger bones as you age.
- Smoking. Smoking puts you at a higher risk for osteoporosis and
increases the rate of bone thinning after it starts.
- Drinking
alcohol. Don't drink more than 2 alcohol drinks a day if you are a man, or 1
alcohol drink a day if you are a woman. Drinking more than this puts you at
higher risk for osteoporosis. Alcohol use also raises your risk of falling and
breaking a bone.
- Not being active. Moderate amounts of
weight-bearing exercise, such as walking and dancing, can help keep bones
strong.7
- Having certain medical problems. Some medical conditions, such as
Ménière's disease, can cause problems with balance or dizziness. Other
conditions such as arthritis can interfere with your ability to be steady as
you walk and move.
- Drug interactions. Sometimes one medicine you
are taking changes the action of another medicine, or the drugs act together to
create unexpected side effects. These can include dizziness or blurred vision
that make falls more likely.
Research also shows that if you have had a spine fracture or,
in men, a Colles fracture
of the wrist, you have an increased
chance of hip fracture.8