Understanding Which Type of Fracture Is Most Common in Adults Greater Than 65

Oct 18, 2025 4 min read •

senior care Orthopedics Healthy Aging

According to the National Institute on Aging, more than one in four people age 65 or older fall each year, and many of these falls result in a broken bone. Among these injuries, understanding which type of fracture is most common in adults greater than 65 is crucial for effective prevention and care.

Quick Summary

Hip fractures are most common in adults over 65, and they are particularly concerning due to their serious health complications, high mortality rate, and significant impact on independence. This is often a result of weakened bones from osteoporosis, making falls more dangerous.

Key Points

Most Common Fracture: The hip is the most common type of fracture in adults over 65, primarily due to falls.
Osteoporosis is a Major Factor: Weakened, brittle bones caused by osteoporosis make seniors more susceptible to fractures from even minor falls or stress.
High Risk of Complications: Hip fractures have serious implications for seniors, including high mortality rates and significant loss of independence.
Prevention is Key: Strategies like managing osteoporosis, fall-proofing the home, and strength-training exercises can greatly reduce risk.
Not Just Hip Fractures: Vertebral compression fractures and wrist fractures are also common fragility fractures that signal underlying bone weakness.
Early Fracture as a Warning: A seemingly minor fracture, like a broken wrist, should trigger a full bone health assessment to prevent more severe injuries.

The Leading Cause of Serious Injury: Hip Fractures

While fractures can occur anywhere, hip fractures are overwhelmingly the most common and devastating type of fracture sustained by adults over 65. This is primarily due to the effects of osteoporosis, a condition characterized by progressive bone mineral density loss. As bones become thinner and more fragile, they are unable to withstand impacts that a younger person's skeleton could easily absorb. A simple fall, a minor trip, or even twisting awkwardly can lead to a severe break in the upper portion of the femur, known as a hip fracture.

Why Hip Fractures Are So Prevalent in Seniors

Several factors contribute to the high incidence of hip fractures in the geriatric population:

Osteoporosis: The vast majority of hip fractures in older adults are related to osteoporosis. The disease weakens bones throughout the body, but the hip and spine are particularly vulnerable. The decline in estrogen levels after menopause is a major contributing factor for women, who are four times more likely to have a hip fracture than men.
Increased Fall Risk: Seniors face a higher risk of falling due to factors like balance issues, muscle weakness, and medication side effects. The combination of fragile bones and a higher likelihood of falling creates a dangerous cycle.
Chronic Health Conditions: Conditions common in older adults, such as Parkinson's disease, arthritis, and vision impairments, can affect mobility and coordination, increasing fall frequency.
Environmental Hazards: Hazards in the home, such as loose rugs, poor lighting, and clutter, are also major contributors to falls.

Other Common Fractures in Older Adults

While hip fractures are the most frequent, other fractures also affect the senior population. Understanding the risks associated with each can help in developing comprehensive prevention strategies.

Vertebral Compression Fractures

Osteoporosis-related fractures often affect the vertebrae in the spine. Vertebral compression fractures (VCFs) can occur from minimal trauma, sometimes simply from coughing, sneezing, or lifting. Symptoms include sudden, severe back pain, loss of height, and a hunched posture, known as a dowager's hump. These fractures can significantly impact mobility and quality of life.

Distal Radius (Wrist) Fractures

Fractures of the wrist, particularly the distal radius, are also common in older adults. These often happen when an individual falls and instinctively tries to break their fall with an outstretched hand. While typically less severe than a hip fracture, a wrist fracture can be a significant indicator of underlying osteoporosis and increases the risk of a future, more serious fracture.

Shoulder and Ankle Fractures

Other fragility fractures occur in the shoulder (proximal humerus) and ankle. Similar to other osteoporosis-related breaks, these often result from low-impact falls. A shoulder fracture can be particularly debilitating, affecting a person's ability to perform daily tasks, while an ankle fracture can lead to prolonged immobility and increased risk of complications.

Comparing Common Fragility Fractures


Feature	Hip Fracture	Vertebral Compression Fracture (VCF)	Distal Radius (Wrist) Fracture
Incidence (Age > 65)	Most common	Very common, often asymptomatic	Frequent, often early indicator
Typical Cause	Falls from a standing height	Minimal trauma (cough, lift)	Fall onto outstretched arm
Severity & Outcomes	High mortality rate, severe disability	Chronic back pain, posture changes	Less severe, but signals high risk
Treatment	Almost always requires surgery	Pain management, stabilization, bracing	Casting or surgical fixation
Long-Term Risk	Greatly increased risk of subsequent fractures	Can lead to further fractures and loss of height	Increased risk of future fractures (e.g., hip)

Prevention Strategies to Protect Seniors

Preventing fractures in older adults involves a multi-faceted approach focusing on bone health, fall prevention, and early detection of osteoporosis.

Lifestyle and Medical Management

Manage Osteoporosis: Regular bone density screenings, especially for postmenopausal women and older men, are essential. Medications may be prescribed to increase bone density.
Nutrition: Ensure adequate intake of calcium and vitamin D through diet and supplements. These nutrients are critical for maintaining strong bones.
Exercise: Regular, weight-bearing exercise, such as walking, tai chi, or light strength training, improves muscle strength, balance, and bone density. A study cited by the [American Academy of Family Physicians] (https://www.aafp.org/) recommends balance, strength, and gait training to reduce fall rates.
Medication Review: Certain medications can cause dizziness, drowsiness, or affect balance. Regular medication reviews with a healthcare provider can help minimize these risks.

Home Safety Modifications

Remove tripping hazards: Clear clutter, secure loose rugs, and keep walkways well-lit.
Install grab bars: Place grab bars in bathrooms, showers, and near toilets for added support.
Ensure adequate lighting: Bright lighting, especially on stairs and in hallways, helps prevent stumbles.
Sturdy footwear: Encourage wearing supportive, low-heeled, non-skid shoes both indoors and outdoors.

The Importance of Early Intervention

Any fracture in an adult over 65 should be a wake-up call to assess for osteoporosis. A wrist fracture, for instance, should not be dismissed as a simple accident. It is often the first indicator of fragile bones and an opportunity to intervene with treatment before a more serious hip fracture occurs.

Conclusion: A Proactive Approach to Protecting Bones

While hip fractures are the most common type of fracture in adults over 65, often with severe consequences, they are not inevitable. By taking a proactive approach to bone health and fall prevention, seniors can significantly reduce their risk. Regular screenings, proper nutrition, targeted exercise, and a safe home environment are all critical components of a comprehensive strategy. Educating older adults and their caregivers about these risks and protective measures can help maintain independence and prevent life-altering injuries.

Frequently Asked Questions

Hip fractures are dangerous for seniors because they often lead to serious complications. These can include a significant decline in mobility and independence, a heightened risk of infection, blood clots, and pneumonia due to prolonged immobility, and a higher mortality rate in the year following the injury.

Yes. In severe cases of osteoporosis, bones can become so brittle that a fracture, such as a vertebral compression fracture in the spine, can occur from minimal stress. Simple actions like a cough, a sneeze, or bending over can cause the weakened vertebrae to collapse.

To reduce the risk of a hip fracture, focus on both bone health and fall prevention. Encourage regular weight-bearing exercise, ensure a diet rich in calcium and vitamin D, and make home safety modifications such as removing rugs, improving lighting, and installing grab bars. Also, have their medications and vision checked regularly.

A wrist fracture (distal radius fracture) in an older adult can be an important warning sign of underlying osteoporosis. It is often the first fragility fracture an individual experiences and indicates a need for a bone density test and possible treatment to prevent future, more serious fractures, like a hip fracture.

A vertebral compression fracture is a break in one of the vertebrae, the bones that make up the spinal column. It is a common type of fracture in older adults with osteoporosis, often resulting in severe back pain, a stooped posture, and a loss of height.

Regular, weight-bearing and balance-focused exercises are most effective. Activities like walking, jogging, dancing, and light strength training help build and maintain bone density. Exercises like Tai Chi are excellent for improving balance and coordination to help prevent falls.

While women, especially post-menopause, have a higher risk of osteoporosis, men are also susceptible and lose bone mass as they age. By age 65 or 70, men and women lose bone mass at a similar rate, and men are at risk for serious fractures, including hip fractures.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.