Q. My partner is 65 and was recently diagnosed with osteoporosis after a bone-density test. She remains active — almost recklessly so. She insists on climbing a ladder to clean our gutters and takes unnecessary risks, like hiking the steep mountain trails near our town. I hesitate to quash her spirit of adventure, but I also don't want her to break every bone in her body in an avoidable fall. What can I do? — A Concerned Spouse
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A. We know why you're scared. The word osteoporosis creates visions of shattered bones and rounded backs. In reality, though, it may just mean your partner has a higher-than-normal risk for fractures. And in the past 15 years, doctors have learned a lot about how to prevent those breaks.
Your spouse may need to change her behavior a little, but she's not a porcelain doll, says Ethel S. Siris, M.D., director of the Toni Stabile Osteoporosis Center at New York – Presbyterian Hospital. "Just make sure she takes enough calcium and vitamin D every day. I generally recommend 1,200 milligrams of calcium from food or supplements, and 1,000 to 2,000 international units of vitamin D." Her doctor may also prescribe a bisphosphonate drug such as Fosamax to lower fracture risk.
Keeping your partner idle could be counterproductive, Siris cautions. Load-bearing exercise such as walking is good for her bones. And an exercise routine can preserve bone mass and improve flexibility, strength, coordination, and balance — all of which can help a person avoid falls.
But what if your spouse values adventure more than her personal safety? "You certainly don't want to diminish her great attitude of being active and engaged," says Harvard psychiatrist Paul Hammerness, M.D. "Be clear about what concerns you, and get the facts so you can have a reasonable conversation."
Emphasize that you want her to keep enjoying her favorite activities — as long as she makes her health an equal priority. For mountain hikes, propose that she go only in daylight, avoid areas known for unstable terrain, wear boots with good traction, carry a walking stick or trekking poles for balance, and take a hiking partner. Remind her that by minding her own safety, she can do what she loves for much longer.
Also of interest: Tai chi helps prevent falls.