Who Is at Risk?

Common Risk Factors

• Age: Risk increases naturally as we get older, particularly after 50.
• Sex: Women are at higher risk, especially after the menopause when protective hormone levels fall.
• Family history: A parent or sibling with osteoporosis or a history of hip fracture increases your risk.
• Previous fractures: A broken bone after a minor fall or bump may signal fragile bones.

Lifestyle Risk Factors

• Smoking — linked to reduced bone strength.
• Excess alcohol — can interfere with bone formation and balance.
• Low calcium or vitamin D intake — vital nutrients for strong bones.
• Low sunlight exposure — increases risk of vitamin D deficiency.
• Lack of exercise — bones and muscles weaken without regular weight-bearing/strength work.
• Very low dietary intake / eating disorders — can reduce bone mass.

Medical Risk Factors

• Early menopause or low sex hormones (including low testosterone in men).
• Long-term steroids or medicines such as aromatase inhibitors, androgen-deprivation therapy, some anti-epileptics, high-dose thyroid hormone, PPIs, SSRIs.
• Chronic conditions: rheumatoid arthritis, thyroid/parathyroid disease, inflammatory bowel disease, coeliac disease, chronic kidney/liver disease, COPD, type 1 diabetes, anorexia.
• Low body weight (BMI < 20) or significant unintentional weight loss.
• Falls risk (poor balance, muscle weakness, vision problems, sedative medications).

Why Risk Matters

Even if you feel well, hidden risk factors can affect your bone strength. Identifying risks early gives you the chance to take action — reducing the chance of fractures, maintaining independence, and protecting long-term health.

• Prevent painful fractures and loss of mobility.
• Keep doing the activities you enjoy for longer.
• Optimise nutrition, exercise, and any medicines at the right time.