Bone health is a concern for many seniors that’s often overlooked. Osteoporosis, a disease that makes bones weak, affects over 10 million Americans. But it’s a “silent disease” that doesn’t show clear symptoms. This means that many seniors don’t realize they have it until they get badly injured by a fall. 

Bold spoke to Dr. Carol Lin, MD, Director of the Geriatric Fracture and Bone Health Programs and orthopaedic surgeon at Cedars Sinai Hospital in Los Angeles, CA. We asked Dr. Lin to help answer your questions about recovering after a fracture, why early prevention matters, and practical steps to keep your bones strong.

Bold: What is a geriatric fracture? How is it different from a fracture in younger people?

Dr. Carol Lin: The term geriatric fracture is a little loaded. It doesn’t just happen when you’re old. These fractures happen when you have low bone density. It’s common for seniors to have weak bones. The problem is usually caused by hormonal changes as we age, especially in women after menopause. Bones lose density over time. Eventually, they become soft enough that even a small fall causes a serious fracture to the pelvis, hip, or spine. Low bone density is “silent” because people don’t feel it. It’s not like a heart attack.

A fracture caused by weak bones is harder to heal than a fracture in strong bones. After a fracture, you need surgery, which is stressful. Your body works hard to heal the bone, which takes a lot of energy and resources. During that time, you’re not moving around. Your appetite isn’t great because you’re taking meds. You don’t feel well, you’re in pain. All the normal things you need to do for recovery are limited—how much you can exercise, how much protein you’re eating. You need to eat and exercise to get muscles to grow. When you are older and already deconditioned, putting in that effort early is difficult, and you get more deconditioned.

Unless we’re committed to exercise and nutrition, our bodies will lose muscle and our bones will get weaker. 

Bold: What does healthy recovery look like after hip fracture surgery?

CL: Everybody’s a little different. The stronger and healthier you are before any surgery, the better you’ll recover. My average patient walks for exercise, doesn’t do weight lifting, is not an athlete, and has a normal diet. My average patient may also have a chronic condition like high blood pressure, prediabetes or moderate diabetes, or a thyroid problem.

To repair a hip fracture after a surgery:

• Patients start by using a walker for 4-8 weeks. 
• By about 3 months after surgery, they are usually using a cane, trying to go for longer walks, and getting back into the gym for low-impact activity and physical therapy. 
• If you were fully independent before, it takes another 3-4 months to get back to your baseline activity. 
• In a typical recovery, you see 50% of total recovery in the first 6 months, then slower gains after that. 
•  By one year, you’re about 80% recovered, with slow improvements beyond that.

Bold: What should men know about bone health?

CL: Men lose bone and muscle mass as their testosterone levels decline. They’re also at risk for osteoporosis. Men should focus on a healthy diet, resistance exercise, and getting a bone health screening at age 70 (or earlier if they have risk factors). 

Bold: As a surgeon, what do you wish more seniors knew about bone health?

CL: Only about 30% of hip fracture patients get the right treatment to prevent another fracture. I’ve seen patients return 9 months later with a fracture in the other hip. It can be devastating. They were just starting to feel more independent again. I want everyone to get their bone density checked. The scan is simple and doesn’t hurt. 

Bold: Why don’t people hear more about osteoporosis?

CL: Mostly because the condition is “silent.” Heart attacks and cancer are dramatic, so people focus more on those. But with weak bones, you become frail and lose your mobility, and your health slowly gets worse. 

Bold: What can seniors do to prevent bone loss and avoid fractures?

CL:

1. Get your bone density tested with a bone scan. Bone scan results can tell us if your risk of a bone fracture is very high. High-risk patients should start taking medication that helps bone health.
2. Make lifestyle changes. Some people with mild bone density loss don’t need medication. They can protect their bone health through nutrition, weight-bearing exercises, protein intake, and vitamin D.
3. Commit to weight-bearing exercise. Bones and muscles don’t respond unless they’re used. I recommend weight-bearing exercises. Use resistance bands, body weight, or weights. And you have to feel challenged. If you do 10 reps of an exercise but aren’t struggling at the end, you’re not changing your body. The goal is to make your body respond.

It’s never too late to start taking care of your bone health. Bold has strength training classes to help you build bone mass, no matter your age. Check if you’re eligible through your health plan and get moving today.