f you’re over 60, every slip on a wet floor or sudden twist in the garden can make you wonder, “Are my bones still strong enough?” Age-related bone loss is common, yet far from inevitable. With the right mix of screening, lifestyle tweaks, and (when necessary) medication, you can keep your skeleton sturdy for decades to come. Let’s explore the latest science and practical steps for maintaining bone density after 60.
Why Bone Density Declines After 60
Hormonal Shifts and Age-Related Remodeling
Bone is living tissue that constantly breaks down (resorption) and rebuilds (formation). After menopause or andropause, falling estrogen or testosterone tilts the balance toward breakdown. Osteoblasts (builders) can’t keep pace with osteoclasts (demolition crew), so bone mineral density (BMD) drops, especially in the spine and hips.
Lifestyle Factors That Accelerate Loss
Sedentary habits, low dietary calcium, vitamin D deficiency, smoking, chronic alcohol intake, and certain medications (e.g., long-term steroids) speed bone thinning. Recognizing these accelerants lets you counteract them early.
Know Your Numbers—Screening & Diagnosis
When to Get a DEXA Scan
Current U.S. Preventive Services Task Force (USPSTF) guidelines call for osteoporosis screening in all women 65 + and in younger postmenopausal women at elevated fracture risk; men 70 + or those with risk factors should discuss testing with their clinicians. A dual-energy X-ray absorptiometry (DEXA) scan is painless, low-radiation, and delivers a T-score comparing your BMD against a healthy 30-year-old.
Understanding T-Scores & FRAX Risk
- Normal: ≥ −1.0
- Osteopenia (low bone mass): −1.0 to −2.4
- Osteoporosis: ≤ −2.5
Combine DEXA results with the FRAX calculator to estimate 10-year fracture probability. A hip-fracture risk ≥ 3 % or major-fracture risk ≥ 20 % usually triggers medication discussion.
Lifestyle Cornerstones for Strong Bones
Targeted Nutrition—Calcium, Vitamin D & Protein
- Calcium: Aim for 1,200 mg/day after age 60. Prioritize low-fat dairy, calcium-set tofu, canned salmon with bones, and fortified plant milks.
- Vitamin D: 600–800 IU daily helps calcium absorption and maximizes response to bone drugs; some adults need higher doses after a blood test PMC.
- Protein: At least 1.0 g per kg body weight supports bone matrix; pair protein with resistance exercise for best results.
Pair calcium-rich foods with vitamin-C sources (bell peppers, citrus) to enhance collagen synthesis within bone.
Weight-Bearing & Resistance Exercise Plans
1. Weight-Bearing Cardio (3–5× week)
- Brisk walking, low-impact aerobics, dancing, or stair climbing—20 minutes minimum.
2. Resistance Training (2–3× week) - Use dumbbells, resistance bands, or body-weight moves (squats, wall push-ups). Aim for 2–3 sets of 8–12 reps per major muscle group.
3. Power Moves (if joints allow) - Light jump-rope intervals or heel drops stimulate hip-bone loading. Start under supervision.
These activities send mechanical signals that tell osteoblasts to lay down fresh mineral deposits.
Balance & Posture Training to Prevent Falls
Tai chi, yoga, and single-leg stance drills improve proprioception and core strength, cutting fall risk by up to 24 % in seniors. Add five-minute balance breaks while brushing teeth or waiting for the kettle.
Medication Options When Lifestyle Isn’t Enough
If you already have osteoporosis or very high FRAX risk, prescription therapy can dramatically cut fracture rates.
Bisphosphonates & Drug Holidays
Alendronate, risedronate, and IV zoledronate slow bone resorption. After 3–6 years of continuous use, many patients take a “drug holiday” to minimize rare side-effects like atypical femur fractures, while switching to a lighter anti-resorptive such as raloxifene.
Anabolic Therapies (Teriparatide, Romosozumab)
Anabolic agents build new bone rather than just slowing loss:
- Teriparatide/Abaloparatide (PTH analogues): Daily injections for up to two years.
- Romosozumab: Monthly injections for 12 months block sclerostin, unleashing rapid bone formation and moderate anti-resorption. Recent data endorses romosozumab as a first-line choice for patients at “imminent” fracture risk and shows significant BMD gains by month 12 PMCUCB.
Monitoring, Side Effects, and Sequencing
Bloodwork checks calcium, kidney function, and vitamin D; repeat DEXA every 1–2 years. Romosozumab originally raised cardiovascular concerns, but a 2025 cohort study found no excess heart-disease risk compared with bisphosphonates.
Optimal sequencing: start with an anabolic (romosozumab or teriparatide) for 12–24 months, then transition to an anti-resorptive to lock in gains—especially useful in severe cases.
Everyday Habits That Protect Bone Health
Limiting Alcohol & Quitting Smoking
Alcohol above two drinks/day impairs calcium absorption and osteoblast function; smoking accelerates estrogen breakdown and reduces blood flow to bone.
Optimizing Sleep & Reducing Stress Hormones
Poor sleep elevates cortisol, which leaches calcium from bones. Aim for 7–8 hours, keep caffeine early, and practice relaxation breathing before bed.
Safe Sun Exposure
Ten minutes of midday sun on arms and legs can produce 1,000 IU of vitamin D—adjust for skin tone and latitude.
Frequently Asked Questions
1. How much calcium and vitamin D do I really need after 60?
1,200 mg calcium and 600–800 IU vitamin D daily; your doctor may recommend up to 2,000 IU if blood levels stay low.
2. What exercises build bone without hurting my joints?
Brisk walking with light hand weights, seated resistance-band rows, water aerobics, and tai chi provide load and balance without high impact.
3. Are bisphosphonate “drug holidays” safe?
Yes for many patients: after 3 years IV or 5 years oral use, fracture protection lingers. Continue lifestyle measures and follow-up scans; your doctor may shift you to a lighter anti-resorptive during the break.
4. Does romosozumab increase heart-disease risk?
Recent real-world data found no significant uptick in cardiovascular events versus bisphosphonate users, though patients with recent heart attack or stroke still warrant caution.
5. How often should I repeat a DEXA scan?
Every 1–2 years for those on medication or with osteopenia; every 3–5 years if initial scan is normal and risk factors are low.
Action Plan: Strong Bones, Confident Life
Protecting bone density after 60 hinges on three pillars: regular screening, load-bearing movement, and optimal nutrition—reinforced by medication when fracture risk climbs. Start with a DEXA scan if you haven’t had one, add two strength sessions to your weekly calendar, and audit your diet for calcium, vitamin D, and protein gaps. Discuss treatment options—including new anabolic agents like romosozumab—with a healthcare professional if your T-score or fracture risk demands extra support.
Ready to put this into practice? Download our free 12-Week Bone-Strength Blueprint («link to Bone-Strength-Blueprint») and review the Mayo Clinic’s bone-health checklist for daily lifestyle reinforcement.
Strong bones build a strong life—make your move today!