Ana Weisman takes Prolia, an injectable shot, twice a year. It helps to slow bone deterioration, crucial for preventing falls and fractures that might have dire consequences for an aging person.
“If you’re in your 20s and 30s and break your wrist or your shoulder, you will heal quickly,” said Weisman’s doctor, Dr. Carlos Sessin.
That’s not usually the case for older individuals.
“As we all age, fractures become a bit more concerning,” said Sessin, chief of rheumatology at Mount Sinai Medical Center in Miami Beach. “They can cause significant health problems.”
Fractures can mean surgery, a difficult recovery and a downward spiral that can lead to one’s death.
According to the American Academy of Orthopaedic Surgeons, fragility fractures are the primary cause of hospitalization or death among adults 65 and older. In 2013, the Centers for Disease Control and Prevention reported the direct medical costs of older adult falls were $34 billion. And both the number of falls and the costs to treat them are likely to increase with the aging of the baby boomers.
For Weisman, 59, who has osteoporosis, Prolia has helped. She also takes vitamin D, critical to absorbing calcium and strengthening your bones, eats healthy foods and exercises by walking and lifting weights. Walking briskly, running and weight training help strengthen your bones.
“So far, so good,” said the Miami Beach resident, who has never had a fracture and has only been in the hospital to deliver her children.
Dr. Jonathan Gottlieb, assistant professor of clinical orthopedics at the University of Miami Miller School of Medicine, believes the first step in preventing falls and fractures is to get past the belief that getting slow and unsteady is really just a natural process of aging.
“It’s really not,” said Gottlieb. “It’s important for patients to contact their primary care doctors if they start to have any signs or suggestion of instability.”
According to the National Osteoporosis Foundation guidelines, all postmenopausal women below age 65, woman age 65 and older, and men age 70 and older should have a bone density test.
A proper medical evaluation, physical therapy and even proper shoe wear can make a difference.
“The worst thing is to have to treat the sequelae of a fall; the best thing is to try to prevent it in the first place,” said Gottlieb, who recommends gait training and exercise.
“If you go to the gym and you practice something, you get good at it. Activities are similar to preparing for a sport, the sport is basically life. You do everything you can to maximize your function.”
Dr. Charles Jordan, orthopedic surgeon at Miami Orthopedics and Sports Medicine Institute at West Kendall Baptist Hospital, agrees that patients must maintain a level of activity.
“Exercise and high level of activity can help with bone health,” said Jordan, who says that exercise and high-impact activities such as running, walking briskly and using weights are correlated with increase bone mineral density. “Bones respond to stress by strengthening themselves.”
Getting about 1,000 to 1,200 milligrams a day of calcium and 600 to 800 international units (IU) of vitamin D is also recommended. Foods rich in vitamin D include fatty fish, like tuna, mackerel, and salmon, dairy products, orange juice fortified with calcium and vitamin D, soy milk, beef liver and egg yolks.
Today people are living longer and with the projected growth in the 65-and-older population, the numbers of fractures will increase. Jordan believes South Florida’s older population today tends to be more active than other generations.
Aurora Trajkovic, 66, a patient of Jordan’s, fractured her femur when stepping out of a motor home three months ago. She underwent hip replacement surgery and now she is back to normal. In the past, a total hip replacement was considered dangerous and a patient’s quality of life would greatly diminish.
Trajkovic, who never missed a day of therapy, recovered quickly and is back to gardening, cleaning her house and playing with her labrador retriever, Pancha.
“Just pay attention to where you step,” said Trajkovic, who didn’t realize the height of the motor home. “I really put a lot of effort and just did my part.”