By the time most of us turn 50, we begin to lose bone density—quietly, steadily, and often without warning signs until it's too late.
The early stage of this loss is called osteopenia, a measurable decrease in bone mineral density that doesn't yet qualify as osteoporosis. When the loss progresses beyond a certain point, the diagnosis shifts to osteoporosis — a condition marked by porous, brittle bones and a significantly increased risk of fractures. (Details here)
Bone loss and muscle loss (Sarcopenia - see related Eldershine post here) often go hand-in-hand — and together, they’re one of the leading causes of diminished function and loss of independence in older adults.
Know Where You Stand
The good news? You can test for it.
A DEXA scan (dual-energy X-ray absorptiometry) measures your bone mineral density and compares it to a healthy young adult's. It’s non-invasive, quick, and either covered by your insurance (especially if you’re over 65) or available for a modest out-of-pocket fee. Knowing your status gives you a powerful tool: clarity.
And clarity leads to action.
Why It Matters
Fragile bones + higher fall risk = dramatically increased risk of early death.
More than 300,000 Americans over 65 are hospitalized every year due to hip fractures — most due to falls, and most have some level of osteopenia or osteoporosis. These injuries often mark the beginning of an irreversibly sharp decline in health, independence, and quality of life.
But it doesn't have to go that way.
What You Can Do
I had a bone density DEXA scan in 2024 and fell into the osteopenia range. My doctor, a busy rural physician who doesn't waste words, said simply, "Take 600 mg of calcium twice a day and lift heavy things." But that's pretty much all I needed to know.
Bone responds to stress — in the best way.
Weight-bearing exercise, especially resistance training, has been shown to help your bones adapt, rebuild, and grow stronger. The LIFTMOR Study (and others like it, here, here, and here) confirmed that heavy resistance training, specifically dead lifts, back squats, and overhead presses, can be safe and effective for older adults with low bone density — when done properly, progressively, and with professional oversight.
Like all exercise programs, you don’t have to start big. But you do have to start. Here's how:
- Talk with your doctor.
- Get a DEXA scan.
- Hire a trainer who understands aging bodies and bone health.
- Progress slowly and consistently.
- Prioritize form and recovery.
Good Coaching is a Non-Negotiable Prerequisite
About 3 months after open heart surgery I was able to start lifting weights - the sternum had fully healed. But I was very careful and very patient. Fortunately, being 69 years old provided me with a "cloak of invisibility", and I was able to use the lightest of weights without embarrassment as I established a new routine of exercise and recovery. At 4 months post-op, I was ready to try deadlifts and squats, two outstandingly effective compound exercises that were integral to the LIFTMOR Study. I asked one of the trainers at my gym if he could show me proper form, and he immediately (and quite vehemently) discouraged me. "You're too old", he said. "You'll hurt yourself. You can do other exercises that will keep you moving without risk. Why do you want to do those dangerous exercises anyway?" Then he showed me some exercises that I barely considered to be warm ups, even in my post-op atrophied state. I politely thanked him and went home - and did an internet search for "local physical therapists specializing in senior strength training". Top of the list was Phoenix Physical Therapy, which featured a section on "Senior Strength and Balance Training" - showing a photo of a man in his 70's performing a dead lift.
I immediately made an appointment and two days later met with a highly-qualified and well-informed physical therapist, Kennedy Willenborg, who was familiar with the LIFTMOR Study and fully supportive of my goals. She first performed a thorough physical history and assessment, then spent a half hour teaching me how to safely perform both the deadlift and squat exercises. She impressed on me the need to start very light, even with just the bare 45 pound bar (or less), and to only add weight when I was able to do so without compromising form. One of my training mantras is, "Patience, Consistency, and Very Mindful Progression". Kennedy reminded me that it was also best to progress my workouts in the following manner - frequency, volume, and then - intensity.
I've been doing squats and deadlifts ever since, a couple of times a week. After 7 weeks I'm using 65-85 pounds on the squats and 95-135 pounds on the deadlifts and feeling a remarkable amount of steady improvement. It's hard work. I'm often sore, but not debilitatingly so. And I already feel the difference in daily activities like climbing stairs and getting up from chairs or the floor. I'll soon go back for another session with Kennedy to check my form now that I've added weight. The point is, I'm absolutely living proof that we seniors are capable of performing challenging exercises safely and effectively.
Supporting Your Efforts
Resistance training is the backbone of bone health, but it’s not the only tool.
Calcium and vitamin D remain essential - but check to make sure, especially with vitamin D, that there are no adverse drug interactions with your current prescriptions.
Other options may include:
- Bisphosphonates (like Fosamax or Boniva), often prescribed for osteoporosis
- Anabolic agents (like Forteo), which promote new bone growth
- Hormone therapy, especially for postmenopausal women
These aren’t for everyone. They carry risks and side effects — but for some, they’re a meaningful part of a comprehensive approach. Always work with a doctor who understands your goals and respects your agency. Research carefully, explore reliable sources, and take it upon yourself to make the most informed choices possible.
Your Foundation, Your Future
Bone loss isn’t inevitable. You can slow it, arrest it, and in many cases, reverse it.
But you have to take action.
You have to move. You have to lift. You have to nourish your bones like your life depends on them — because it does.
This is the work. This is the path to a longer, stronger healthspan.
No matter your age, your diagnosis, or your history — you are not too far gone.
You're not fragile. You're rebuilding.
Keep your foundation sound.