Topic Overview

In older adults, hip fractures are usually caused by a fall. Even a slight fall can sometimes cause a fracture in a weakened hipbone. Children and young adults are more likely to break a hip because of a bike or car accident or a sports injury.

Falls cause more fractures—including hip fractures—as people age because, starting at about age 30, bone begins to be reabsorbed by the body faster than it is replaced. Over time, it naturally gets thinner (less dense), weaker, and breaks more easily. If bones thin a certain amount, you are said to have osteoporosis. Both osteoporosis and hip fracture affect women more often than men, because men have higher bone density than women and because of the decrease in the hormone estrogen in women after menopause. Having lower levels of estrogen speeds up bone loss and results in weakened bones. Lower levels of testosterone in men can also speed up bone loss.

Although men are also at risk for hip fracture as they age, women have lower bone density to begin with, more bone loss after middle age, and live longer than men. As a result, most hip fractures occur in women.

Some medicines are related to bone loss or to fractures. These include:

• Antacids that contain aluminum.
• Corticosteroids used to treat conditions such as asthma and chronic obstructive pulmonary disease (COPD).
• Antidepressant medicines called SSRIs (selective serotonin reuptake inhibitors).

Other things that increase the risk for hip fracture include:

• Your family history (heredity). Being thin or tall, or having family members who had fractures later in life increases your risk.
• Race. White and Asian people have a higher risk of osteoporosis. Osteoporosis raises the risk of a fracture if you fall, so the risk of hip fracture is also higher in whites and Asians.
• Poor eating habits. Eat a nutritious diet that includes adequate amounts of calcium and vitamin D. Both are needed for building healthy, strong bones.
• Smoking. Smoking puts you at a higher risk for osteoporosis and increases the rate of bone thinning after it starts.
• Drinking alcohol. Don’t drink more than 2 alcoholic drinks a day if you are a man, or 1 alcohol drink a day if you are a woman. Drinking more than this puts you at higher risk for osteoporosis. Alcohol use also raises your risk of falling and breaking a bone. See pictures of standard alcoholic drinks.
• Not being active. Moderate amounts of weight-bearing exercise, such as walking and dancing, can help keep bones strong.
• Having certain medical problems. Some medical conditions, such as Ménière’s disease, can cause problems with balance or dizziness. Other conditions such as arthritis can interfere with your ability to be steady as you walk and move.
• Drug interactions. Sometimes one medicine you are taking changes the action of another medicine, or the drugs act together to create unexpected side effects. These can include dizziness or blurred vision that make falls more likely.

Research also shows that if you have had a spine fracture or, in men, a Colles fracture of the wrist, you have an increased chance of hip fracture.^{footnote 1}