Basic measures for maintaining bone health

  • Maintain body weight, e.g. >57 kg in women of average height.
  • Undertake regular weight-bearing and muscle strengthening exercises to reduce the risk of falls and fractures.
  • Maintain calcium intake >1-1.5g/day (4-6 servings dairy products, or equivalent in supplement form).
  • Avoid vitamin D insufficiency, i.e. maintain serum 25-hydroxyvitamin D between 50-150nmol/l – especially a problem for frail elderly. In this high risk population empirical treatment may be indicated and is safe and more cost effective than laboratory testing.
  • Avoid glucocorticoid drugs (e.g. prednisone); administer locally if possible.
  • Avoid an alcohol intake of more than 2 standard drinks per day.
  • Stop smoking.
  • Create safe environments for older people with appropriate modifications for visual and hearing impairment, e.g. install hand rails, remove loose rugs and cords, etc.
  • Avoid medications that may increase fall risk, especially sedatives.
  • Consider hip protectors if the patient has a high risk of falling.