Osteoporosis weakens bones to the point that they can break easily. It is called a “silent disease” because people who develop it may not notice any changes until a bone breaks — usually a bone in the hip, spine, or wrist.

Bones are made of living tissue. To keep them strong, a healthy human body breaks down old bone and replaces it with new bone. Osteoporosis develops when more bone is broken down than replaced.

The inside of a bone looks something like a honeycomb. When someone has osteoporosis, the bone, which forms the “walls” of the honeycomb, get smaller, and the spaces between the bone grow larger. The outer shell of the bone also gets thinner. All of this makes a bone weaker.

In serious cases of osteoporosis, a simple motion such as a cough or minor bump can result in a broken bone, also called a fracture. People with osteoporosis also have a harder time recovering from broken bones, which can sometimes cause pain that does not go away. Broken hip and spine bones are especially serious, as these injuries can cause older adults to lose their mobility and independence.

Who is at risk for osteoporosis?

While people of all races and ethnic groups can develop osteoporosis, certain groups are more likely to develop the disease. Osteoporosis affects about one in five women over age 50, but only one in 20 men. Among women, those of White and Asian descent are more likely to develop osteoporosis. Other risk factors for osteoporosis include:

• A family history of broken bones or osteoporosis
• History of a broken bone after age 50
• Previous surgery to remove the ovaries before menstruation periods stopped naturally
• Poor dietary habits, including insufficient amounts of calcium and/or vitamin D or protein
• Physical inactivity or prolonged periods of bedrest
• Smoking cigarettes
• Heavy use of alcohol
• Long-term use of certain medications, such as corticosteroids, proton pump inhibitors, and antiepileptic medications
• Altered levels of hormones, such as too much thyroid hormone, too little estrogen in women, or too little testosterone in men.
• Low body mass index or underweight

The risk of developing osteoporosis increases as people grow older. At the time of menopause, women may lose bone mass quickly for several years. After that, the loss slows down but continues. In men, the loss of bone mass is slower. By age 65 or 70, men and women lose bone mass at the same rate.

How is osteoporosis diagnosed?

Osteoporosis rarely has any symptoms. In fact, some people may not notice any changes until a minor bump or fall causes a bone to break. Don’t wait for a potential accident to determine if you have osteoporosis.

If you are a woman over age 65, the U.S. Preventive Services Task Force recommends that you get tested for osteoporosis. Women younger than 65 who are at greater risk should also get tested. The task force does not recommend regular screening for men. Men lose bone density more slowly than women but should still be aware of the possibility of developing osteoporosis. Older men who break a bone easily or who are at risk for osteoporosis should talk with their doctor about testing and treatment.

Health care providers can measure how strong bones are with a bone density scan. This test compares a person’s bone density to the bones of an average healthy young adult. The test result, known as a T-score, indicates whether a person has osteoporosis or osteopenia, which is low bone density that’s not as severe as osteoporosis. Your doctor may also use other screening tools, including questionnaires, physical exams, and ultrasounds, to predict your risk of having low bone density or breaking a bone.

How is osteoporosis treated?

Treating osteoporosis means slowing or stopping the bone loss to prevent breaks. If your test results show that you have osteoporosis or bone density below a certain level and you have other risk factors for fractures, your doctor may recommend lifestyle changes and medications to lower your chances of breaking a bone.

The same healthy lifestyle choices that help prevent osteoporosis can be used to treat it. These include exercising regularly and eating a healthy diet. However, lifestyle changes may not be enough if you have lost a lot of bone density. There are also several medications to consider. Some can slow your bone loss and others can help rebuild bone.

Medications that slow down bone loss include bisphosphonates, calcitonin, RANKL blockers, estrogen, and drugs that change how estrogen acts in the body.

Medications that help rebuild bone include a synthetic version of the parathyroid hormone and drugs that inhibit a protein called sclerostin.

Talk with your doctor to see if there is a medication that can help you manage your osteoporosis.

In addition to managing your osteoporosis, it’s important to avoid activities that may cause a fracture. Such activities include movements that involve twisting your spine, like swinging a golf club, or bending forward from the waist, like sit ups and toe touches.

You can also help reduce the risk of breaking a bone by preventing falls. For individuals with weakened bones, falling is more likely to cause a fracture. Additionally, broken bones in people with osteoporosis may not heal properly and could cause persistent pain, leading to a loss of mobility and independence.

How can I keep my bones strong as I age?

There are things you can do at any age to prevent weakened bones. Here are some tips:

• Eat foods that support bone health. Get enough calcium, vitamin D, and protein each day. Low-fat dairy; leafy green vegetables; fish; and fortified juices, milk, and grains are good sources of calcium. If your vitamin D level is low, talk with your doctor about taking a supplement.
• Get active. Choose weight-bearing exercise, such as strength training, walking, hiking, jogging, climbing stairs, tennis, and dancing. This type of physical activity can help build and strengthen your bones.
• Don’t smoke. Smoking increases your risk of weakened bones. If you do smoke, here are tips for how to quit smoking.
• Limit alcohol consumption. Too much alcohol can harm your bones. Drink in moderation or not at all. Learn more about alcohol and aging.

To learn more, please visit https://www.nia.nih.gov/health/osteoporosis/osteoporosis.

As you age, it is normal to notice changes in your vision. A few common changes for older adults include:

• Losing the ability to see up close
• Having trouble distinguishing colors, such as blue from black
• Needing more time to adjust to changing levels of light

These problems are often easily corrected. Glasses, contact lenses, and improved lighting may help and enable you to maintain your lifestyle and independence.

Your risk for some eye diseases and conditions increases as you grow older, and some eye changes are more serious. Keep your eyes as healthy as possible by getting regular eye exams so any problems can be spotted early.

What can you do to protect your vision?

Have your eyes checked regularly by an eye care professional — either an ophthalmologist or optometrist. Finding and treating any problems early can help protect your vision and prevent vision loss. Make a list of your questions and concerns to share with the doctor. Tell them which medications you are taking. Some can affect your eyes.

Normal changes in the aging eye usually do not harm your vision. However, sometimes they can be signs of a more serious problem. For example, your eyes may leak tears. This can happen with light sensitivity, wind, or temperature changes. Sunglasses and eye drops may help. Sometimes, leaking tears may be a symptom of dry eye or sign of an infection or blocked tear duct. Your eye care professional can treat these problems.

Many people don’t notice any signs or symptoms in the early stages of eye diseases. A dilated eye exam performed by an eye care professional is the only way to find some common eye diseases while they’re easier to treat — and before they cause vision loss. Everyone over age 50 should have a dilated eye exam every year or as recommended by your eye care professional, even if you have good vision and don’t wear contacts or glasses. After age 60, you should get a dilated eye exam every year or two. Most people with diabetes or high blood pressure need to get a dilated exam at least once a year.

During this exam, the eye care professional will put drops in your eyes to widen (dilate) your pupils so that he or she can better see inside each eye. Your vision may be blurry after the exam, and your eyes may be more sensitive to light. This only lasts a few hours. Make plans for someone else to drive you home.

If you wear glasses or contact lenses, get your prescription checked, too. Even small changes in sight can increase your risk for falls and injuries. It’s important to use the proper prescription glasses or contact lenses.

See your primary health care provider regularly to check for diseases like diabetes and high blood pressure. These diseases can cause eye problems if not controlled or treated.

Eye diseases and conditions

The following eye problems can lead to vision loss and blindness in older adults. They may have few or no early symptoms. Regular eye exams are your best protection. If your eye care professional finds a problem early, often there are things you can do to protect your vision.

• Age-related macular degeneration (AMD) can harm the sharp, central vision needed to see objects clearly and to do common things like driving and reading. Your eye care professional will ask about your family history and look for signs of AMD during a dilated eye exam. Treatments are available, and special dietary supplements can help lower your chance of it getting worse.
• Diabetic retinopathy may occur if you have diabetes. It develops slowly, often with no early warning signs. If you have diabetes, be sure to have a dilated eye exam at least once a year. Keeping your blood sugar, blood pressure, and cholesterol under control can prevent diabetic retinopathy or slow its progress in early stages. Laser surgery in later stages can sometimes prevent it from getting worse.
• Cataracts are cloudy areas in the eye’s lens causing blurred or hazy vision. Some cataracts stay small and don’t change your eyesight much. Others become large and reduce vision. Cataract surgery can restore good vision and is a safe and common treatment. If you have a cataract, your eye care professional will watch for changes over time to see if you would benefit from surgery.
• Glaucoma is usually caused by too much fluid pressure inside the eye. If not treated, it can lead to vision loss and blindness. People with glaucoma often have no early symptoms or pain. You can help protect yourself by having dilated eye exams yearly. Glaucoma can be treated with prescription eye drops, lasers, or surgery.
• Dry eye occurs when tear glands don’t work well. You may feel stinging or burning, a sandy feeling as if something is in the eye, or other discomfort. Dry eye is common as people get older, especially for women. Your eye care professional may tell you to use a home humidifier or air purifier, special eye drops (artificial tears), or ointments to treat dry eye. For more severe cases, treatment options might include prescription medication, tear duct plugs, or surgery.

What is low vision?

Low vision means you cannot fix your eyesight with glasses, contact lenses, medication, or surgery. Low vision affects some people as they age. You may have low vision if you:

• Can’t see well enough to do everyday tasks like reading or cooking
• Have difficulty recognizing the faces of your friends or family
• Have trouble reading street signs
• Find that lights don’t seem as bright

If you have any of these problems, ask your eye care professional to test you for low vision.

Vision rehabilitation programs and special aids, such as a magnifying device, can help you adapt to vision loss and make the most of your remaining sight. There are also programs, such as the National Library Service, that link people who have low vision or visual disabilities to resources at no cost.

Remember to ask your eye doctor if it is safe for you to drive with your vision. If you have to stop driving, organizations in your area may be able to arrange rides for you, or public transportation may be available.

Other tips that may help:

• Brighten the lighting in your room.
• Write with bold, black felt-tip markers.
• Use paper with bold lines to help you write in a straight line.
• Put colored tape on the edge of any stairs in your home to help you see them and prevent you from falling.
• Install dark-colored light switches and electrical outlets so that you can see them easily against light-colored walls.
• Use motion lights that turn on when you enter a room. These may help you avoid accidents caused by poor lighting.
• Use clocks with large numbers and phones with large screens; put large-print labels on the microwave and stove.

To learn more, please visit https://www.nia.nih.gov/health/vision-and-vision-loss/aging-and-your-eyes.

Over time, people with Alzheimer’s disease will become less able to manage things around the home. For example, they may forget to turn off the oven or faucet, or even how to use the phone in an emergency. People with Alzheimer’s also may not see, smell, touch, hear, or taste things as they used to.

Caregivers can do many things to make the person’s home a safer place. The tips on this page cover a wide range of safety concerns that may arise — some may not apply to your current circumstances. It is important, however, to keep thinking about home safety as the person’s behavior and abilities change.

Creating a Safer Home for a Person with Alzheimer’s

Go through the house room by room to identify potential problems and safety issues. First, correct any immediate dangers, such as loose stair railings and poor lighting, and then work on other ways to ensure the person will be as safe as possible at home.

To prevent falls, mark the edges of steps with brightly colored tape so the person can see the steps as they go up or down stairs.

• Use brightly colored signs or simple pictures to label the bathroom, bedroom, and kitchen.
• Limit the size and number of mirrors in your home and be specific about where you put them. Mirror images may confuse a person with Alzheimer’s.
• Make the walls a lighter color than the floor to create contrast. Avoid busy patterns.
• Install safety latches on storage cabinets and drawers designated for breakable or dangerous items.
• Set the water heater to 120°F to avoid scalding tap water.
• Label hot-water faucets red and cold-water faucets blue and/or write the words “hot” and “cold” near them.
• Pad any sharp corners on your furniture or replace or remove furniture with sharp corners.
• Place decals at eye level on sliding glass doors, picture windows, or furniture with large glass panels to identify the glass pane.
• Consider a “NO SOLICITING” sign for the front gate or door.
• Use smoke detectors and natural gas detectors and check their functioning and batteries frequently. People with Alzheimer’s may not be able to smell smoke or an unlit gas stove.
• Install nightlights and/or automatic light sensors.
• List emergency phone numbers (such as ambulance, poison control, and doctors) and the person’s address near all phones.

Store potentially dangerous items in a locked area or remove them from the home. These items can include:

• Prescription and over-the-counter medicines
• Alcohol
• Cleaning and household products, including paint thinner, matches, rubbing alcohol, and laundry detergent pods
• Poisonous plants
• Guns and other weapons, scissors, knives, power tools, and machinery
• Gasoline cans and other flammable items

Learn basic first aid in case the person gets sick or injured. Learn the Heimlich maneuver and CPR, and when to use each. Check with your local hospital or American Red Cross chapter about health and safety classes.

Kitchen Safety

• Put signs near the oven, toaster, iron, and other things that get hot. The sign could say, “Stop!” or “Don’t Touch — Very Hot!” Be sure the sign is not so close that it could catch fire.
• Check foods in the refrigerator often. Throw out any that have gone bad.
• Add safety knobs and an automatic shut-off switch on the stove.
• Consider disconnecting the garbage disposal.
• Insert a drain trap in the kitchen sink to catch anything that may otherwise become lost or clog the plumbing.
• Remove artificial fruits and vegetables or food-shaped kitchen magnets, which may seem edible to the person with Alzheimer’s.

Bedroom Safety

• Use a room monitoring device (like those used for infants) to alert you to any sounds indicating a fall or other need for help during the night.
• Remove portable space heaters. If you use portable fans, be sure that objects cannot be placed in the blades.
• Be cautious if using electric mattress pads, electric blankets, electric sheets, and heating pads, all of which can cause burns and fires. Keep controls out of reach of the person with Alzheimer’s.
• Install bed rails and other transfer or mobility aids.

Bathroom Safety

• Remove small electrical appliances from the bathroom and cover electrical outlets.
• Put away or lock up items such as toothpaste, lotions, shampoos, soap, and perfume. They may look and smell like food to a person with Alzheimer’s.
• Install grab bars in the tub/shower. A grab bar in contrasting color to the wall is easier to see.
• Use a raised toilet seat with handrails or install grab bars beside the toilet.
• Place nonskid adhesive strips, decals, or mats in the tub and shower. If the bathroom is uncarpeted, consider placing these strips next to the tub, toilet, and sink.
• Use a foam rubber faucet cover in the tub, plastic shower stool, and hand-held shower head.

Find more information here: Alzheimer’s Caregiving: Bathing, Dressing, and Grooming.

To learn more, please visit https://www.nia.nih.gov/health/safety/alzheimers-caregiving-home-safety-tips.

Hearing loss is a common problem caused by loud noise, aging, disease, and genetic variations. About one-third of older adults have hearing loss, and the chance of developing hearing loss increases with age. People with hearing loss may find it hard to have conversations with friends and family. They may also have trouble understanding a doctor’s advice, responding to warnings, and hearing doorbells and alarms.

Some people may not want to admit they have trouble hearing. Hearing problems that are ignored or untreated can get worse. If you have a hearing problem, see your doctor. Hearing aids, special training, certain medications, and surgery are some of the treatments that can help.

Signs of hearing loss

Some people have a hearing problem and don’t realize it. You should see your doctor if you:

• Have trouble understanding what people are saying over the telephone
• Find it hard to follow conversations when two or more people are talking
• Often ask people to repeat what they are saying
• Need to turn up the TV volume so loud that others complain
• Have a problem understanding speech because of background noise
• Think that others seem to mumble
• Can’t understand what’s being said when children and people with higher pitched voices speak to you

Types of hearing loss

Hearing loss comes in many forms. It can range from a mild loss, in which a person misses certain high-pitched sounds, to a total loss of hearing.

Sudden hearing loss

Sudden deafness, also known as sudden sensorineural hearing loss, is an unexplained rapid loss of hearing. It can happen to a person all at once or over a period of a few days. It should be considered a medical emergency. If you or someone you know experiences sudden hearing loss, visit a doctor immediately.

Age-related hearing loss

Age-related hearing loss, also called presbycusis, comes on gradually as a person grows older. It seems to run in families and may occur because of changes in the inner ear and auditory nerve, which relays signals from the ear to the brain. Presbycusis may make it hard for a person to tolerate loud sounds or to understand what others are saying.

Age-related hearing loss usually occurs in both ears, affecting them equally. Because the loss is gradual, people with presbycusis may not realize they have lost some of their ability to hear.

Tinnitus

Tinnitus is also common in older people. It is typically described as ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It can come and go. It can be heard in one or both ears, and it may be loud or soft. Tinnitus is sometimes the first sign of hearing loss in older adults. It can accompany any type of hearing loss.

Tinnitus is a symptom, not a disease. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus. It can also be a sign of other health conditions, such as high blood pressure or allergies. Tinnitus can also occur as a side effect of certain medications.

Causes of hearing loss

Loud noise is one of the most common causes of hearing loss. Noise from lawn mowers, snow blowers, or loud music can damage the inner ear and result in permanent hearing loss. Loud noise also contributes to tinnitus. You can prevent most noise-related hearing loss by turning down the sound on your devices, moving away from loud noise, or using earplugs or other ear protection.

Earwax or fluid buildup can also cause hearing loss by blocking sounds that are carried from the eardrum to the inner ear. If wax blockage is a problem, your doctor may suggest mild treatments to soften earwax.

A ruptured eardrum can also cause hearing loss. The eardrum can be damaged by infection, pressure, or putting objects in the ear, including cotton-tipped swabs. See your doctor if you have ear pain or fluid draining from an ear.

Health conditions common in older people, such as diabetes or high blood pressure, can contribute to hearing loss. Ear infections caused by viruses and bacteria (also known as otitis media), a heart condition, stroke, brain injury, or a tumor may also affect your hearing.

Hearing loss can also result from taking certain medications that can damage the inner ear, sometimes permanently. These medications may be used to treat serious infections, cancer, or heart disease. They also include some antibiotics, and even aspirin at some dosages. If you notice a problem while taking a medication, check with your doctor.

Genetic variations can cause hearing loss as well. Not all inherited forms of hearing loss are evident at birth. Some forms can show up later in life. For example, otosclerosis, which is thought to be a hereditary disease, involves the abnormal growth of bone that prevents structures within the ear from working properly.

Health effects of hearing loss

Hearing loss can affect cognitive health. Studies have shown that older adults with hearing loss have a greater risk of developing dementia than older adults with normal hearing. Cognitive abilities (including memory and concentration) decline faster in older adults with hearing loss than in older adults with normal hearing. A recent analysis of several studies found that people who used hearing restorative devices (such as hearing aids and cochlear implants) had a lower risk of long-term cognitive decline compared to people with uncorrected hearing loss.

Older people who can’t hear well may become depressed or withdrawn from others because they feel frustrated or embarrassed about not understanding what is being said. Sometimes, older people are mistakenly thought to be confused, unresponsive, or uncooperative because they don’t hear well. These circumstances can lead to social isolation and loneliness.

Hearing loss, even small amounts, is also linked to an increased risk for falls. It also can affect public as well as personal safety, such as the ability to drive safely, when warning sounds are harder to hear.

How to cope with hearing loss

If you notice signs of hearing loss, talk with your doctor. If you have trouble hearing, you should:

• Let your family and friends know you have a hearing problem.
• Ask people to face you and to speak louder and more clearly. Ask them to repeat themselves or reword what they’re saying.
• Pay attention to what is being said and to facial expressions or gestures.
• Let the person talking know if you do not understand what was said.
• Find a good location to listen. Place yourself between the speaker and sources of noise or look for quieter places to talk.

The most important thing you can do if you think you have a hearing problem is to seek professional advice. Your family doctor may be able to diagnose and treat your hearing problem. Or your doctor may refer you to other experts, like an otolaryngologist (ear, nose, and throat doctor) or an audiologist (health professional who can identify and measure hearing loss).

Devices to help with hearing loss

Many types of assistive devices are available to help people with hearing loss. These devices can amplify sounds, provide alerts, and help you communicate with others. For example, alert systems work with doorbells, smoke detectors, and alarm clocks to send visual signals or vibrations. Devices that use keyboards, touch screens, or text-to-speech technology can help you give and receive information more effectively. Learn more about the wide range of assistive devices available for people with hearing loss from the National Institute on Deafness and Other Communication Disorders.

Hearing aids are electronic, battery-run assistive devices that make some sounds louder. There are two main ways to get a hearing aid: by prescription or over the counter.

• An audiologist or hearing aid specialist can prescribe hearing aids for people with significant or complicated hearing loss. Prescription hearing aids require a medical exam, and then the health care professional will fit and adjust the device.
• Hearing aids have recently become available without a prescription. Over-the-counter hearing aids, which are sold in stores and online, may help people with mild to moderate hearing loss.

Before buying a hearing aid, find out if your health insurance will cover part of the cost.

A cochlear implant is a different type of assistive device that can help people who are profoundly deaf or hard of hearing. Whereas hearing aids make sound louder so damaged ears can hear it, cochlear implants create electric signals that the brain recognizes as sound. The implant requires surgical placement and hearing therapy.

If you are experiencing hearing loss, talk with your doctor about assistive devices that may be available to help.

How to talk with someone who has hearing loss

Here are some tips you can use when talking with someone who has a hearing problem:

• In a group, make a point to include people with hearing loss in the conversation.
• Find a quiet place to talk to help reduce background noise, especially in restaurants and at social gatherings.
• Stand in good lighting and use facial expressions or gestures to give clues.
• Face the person and speak clearly. Maintain eye contact.
• Speak a little louder than normal, but don’t shout.
• Try to speak naturally and at a reasonable speed.
• Do not hide your mouth, eat, or chew gum while speaking.
• Repeat yourself if necessary, using different words.
• Try to make sure only one person talks at a time.
• Be patient. People with hearing loss may also be frustrated by their condition. Stay positive and relaxed.
• Ask how you can help.

To learn more, please visit https://www.nia.nih.gov/health/hearing-and-hearing-loss/hearing-loss-common-problem-older-adults.