Most fractures in older people are caused by the combination of weak bones (such as from osteoporosis) and a fall. As you get older, your bones get weaker from natural bone tissue changes. After menopause, the decline in the female hormone estrogen also makes your bones thinner. Other medical conditions, medications, cigarette smoking, alcohol, and your genetic predisposition may all contribute to more severe loss of bone with aging. In addition, your risk of falling increases because your balance and vision become less acute, reflexes slow down, and coordination worsens. 

When bones become frail and brittle, even a small move can be enough to cause a fracture. For example, lifting something, bending forward, or stepping down harder than usual may cause a vertebral fracture (break in one of the bones of your back). 

Risk Factors

Simply getting older increases your risk of sustaining a fracture. But if you have any of the following conditions, your chances rise: 

  • Osteoporosis or osteopenia (loss of bone mass)
  • Diseases of the bones such as Paget’s disease, cancer, or rheumatoid arthritis
  • Kidney failure requiring dialysis
  • Medications (for example, long-term medicines used for asthma [such as prednisone and other corticosteroids], medications for high blood pressure, seizures, breast cancer, or thyroid conditions, and blood thinners, anxiety medications, and sleeping pills)
  • Female gender
  • White race
  • Intestinal problems that prevent you from absorbing nutrients well
  • Long-term alcohol misuse or tobacco habit
  • Inactive (sedentary) lifestyle
  • Hyper-thyroid and hyper-parathyroid disease
  • Osteomalacia (a bone disorder related to inadequate vitamin D in older people)
  • History of prior fracture
  • Parent(s) with a history of hip fracture


Last Updated June 2020