Losing significant height as one ages is not inevitable, says bone health expert

It is not inevitable that individuals will get shorter or stooped as they age – a significant loss of height as one ages is a sign of osteoporosis, which can be prevented or slowed down, says an expert from global health system Cleveland Clinic ahead of World Osteoporosis Day on 20 October.

Osteoporosis is a disease that weakens bones and puts them at greater risk for sudden and unexpected fractures. According to the International Osteoporosis Foundation, it is the most common bone disease, affecting one in three women and one in five men over the age of 50 worldwide.

Cleveland Clinic rheumatologist Abby G. Abelson, MD, MACR explains that the disease often develops without any symptoms or pain, and usually is not discovered until the weakened bones cause painful fractures.

“Most of these are fractures of the hip, wrist, and spine. Spine and hip fractures can be dangerous because they often cause chronic pain and disability, and they are more likely than other broken bones to lead to long-term problems,” says Dr. Abelson.

Up until about age 30, Dr. Abelson says, individuals normally build more bone than they lose. However, after age 35, bone breakdown occurs faster than bone buildup, which causes a gradual loss of bone mass. If individuals have osteoporosis, they lose bone mass at a greater rate. In women, , the rate of bone breakdown occurs even more quickly after menopause.

However, although individuals might be more at risk to develop osteoporosis as they get older, the good news is that steps can be taken to avoid it, Dr. Abelson says.

Osteoporosis and height loss

Commenting on the link between osteoporosis and height loss, Dr. Abelson says that losing a little height as you age is normal since the discs between the spine’s vertebrae flatten, the muscles start to lose mass and the spaces between the joints narrow. However, a significant loss in height can signal osteoporosis, she says.

“A lot of people are under the misconception that losing height is normal,” she says. “Certainly losing a half-inch, or three quarters of an inch – less than 2cm – may be normal, but I’ve seen patients who say they’ve lost two, three, or four inches in height, and they thought that was a natural consequence of aging, but it’s not.”

How to avoid bone loss

“We now have many safe and effective medications to prevent the fractures that are caused by osteoporosis, but it is also critical to prevent bone loss and fractures by addressing risk factors that you can control,” Dr. Abelson says.

According to Dr. Abelson, diet and lifestyle are two important risk factors that individuals can control to prevent osteoporosis. “That means eating a diet rich in calcium throughout your life. You should aim to get 1,200 milligrams of calcium per day to help prevent bone loss. Regular physical activity can also help a lot. Exercises that make your muscles work against gravity, such as walking, jogging, aerobics, and weightlifting, are best for strengthening bones. Individuals should also avoid smoking and excessive alcohol intake,” she says.

In addition, it is important to spot problems early, as in some cases, suffering a fracture can be life-changing, according to Dr. Abelson. “People are more likely to die in the year after a hip fracture. People are more likely to die after a spine fracture as well. That’s why we want to be really proactive about diagnosing this early.”

Screening for bone density typically begins around the time of menopause for women – in their mid- to late-40s, while men usually begin screening in their mid-60s. “It’s also a good idea to get a bone density evaluation if you’ve had any broken bones as an adult,” Dr. Abelson concludes.