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Risk factors
By Mayo Clinic staffA combination of factors may increase your risk of a hip fracture, including:
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Age. The rate of hip fractures increases substantially with age. As you age, your bone density decreases, your vision and sense of balance decline, and your reaction time slows. If you're inactive, your muscles tend to weaken as you age. All of these factors combined can increase your risk of a hip fracture.
Each year, more than one-third of Americans older than 65 experience a fall at some point, and nearly 2 million end up in hospital emergency rooms due to those falls. More than 300,000 Americans fracture their hip, and about half of them are older than 80.
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Chronic medical conditions. Osteoporosis is a major risk factors for hip fracture. In osteoporosis, the structure of your bones becomes weaker because your bones don't contain as much calcium and other minerals. A weaker structure makes your bones more prone to a fracture, even with relatively minor trauma.
Other medical conditions also may lead to bone fragility either by slowing bone formation or by speeding up bone loss. These include endocrine disorders, such as hyperthyroidism; gastrointestinal disorders, which may interfere with calcium and vitamin D absorption; and rheumatoid disorders, which often lead to inactivity and loss of bone mass. Low levels of the sex hormones testosterone and estradiol (a form of estrogen) — a condition known as hypogonadism — are associated with an increased risk of osteoporosis.
Chronic conditions that affect your nervous system can increase your risk of falling, such as Parkinson's disease and multiple sclerosis. Decreased mental alertness, such as that caused by dementia or depression, also increases the risk of falling.
- Sex. About 80 percent of hip fractures occur in women. Women lose bone density at a faster rate than men do. The drop in estrogen levels that occurs with menopause accelerates bone loss, increasing the risk of hip fractures as a woman moves beyond menopause. However, men also can develop dangerously low levels of bone density.
- Heredity. Genetic factors influence bone size, bone mass and bone density. A family history of osteoporosis or fractures later in life is a strong predictor of low bone mass, although not necessarily of fractures themselves. A small-boned, slender frame may put you at increased risk of osteoporosis. Also, Caucasians and Asians have the highest risk of osteoporosis.
- Nutrition. Lack of calcium and vitamin D in your diet when you're young lowers your peak bone mass and increases your risk of fracture later in life. Serious eating disorders, such as anorexia nervosa and bulimia, can damage your skeleton by depriving your body of essential nutrients needed for bone building. A high caffeine intake may interfere with the absorption of vitamin D and calcium, resulting in decreased bone density.
- Physical inactivity. Weight-bearing exercises, such as walking, help strengthen bones and muscles, making falls and fractures less likely. If you don't regularly participate in weight-bearing exercise, you may have lower bone density and weaker bones. Additionally, prolonged bed rest or immobility can lead to bone loss.
- Tobacco and alcohol use. Smoking and excessive consumption of alcohol can interfere with the normal processes of bone building and remodeling, resulting in bone loss.
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Medications. Certain medications can accelerate bone loss, increasing your risk of osteoporosis and hip fracture. Long-term use of corticosteroids, such as prednisone, may lower bone mass. Other medications that may contribute to bone loss or to calcium or vitamin D deficiencies if used for long periods of time include anticonvulsants, thyroid medications, and certain diuretics and blood thinners.
Some research has suggested that the long-term use of proton pump inhibitors to reduce stomach acid is linked with a higher risk of hip fracture, possibly by affecting the way calcium is absorbed. If you're taking these medications, ask your doctor if you need to take additional calcium.
Some drugs may affect your balance and cause dizziness, including certain blood pressure medications, sedatives, tranquilizers, antidepressants, cold and allergy medications, pain relievers and sleep medications.
- Environmental hazards. Loose rugs, cluttered floors, poor lighting, exposed electrical or telephone cords, and stairs with no handrails may increase your risk of stumbling and falling.
