Activity and Health vs. Risk of Injury: Cause for Osteoporosis

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OAKLAND, CA - JULY 15:  A senior receives a co...

OAKLAND, CA - JULY 15: A senior receives a complimentary blood pressure check during the 8th Annual Healthy Living Festival. (Image credit: Getty Images via @daylife)

How risk aversion and lifestyle-change contributes greatly to osteoporosis, and osteopenia development

As individuals age, activities that involve loading the body (e.g. lifting heavy objects, running, jumping, etc.) become, in the minds of almost every individual, increasingly associated with the risk of injury. When a child or young adult is injured, he or she can recover quickly and lifestyle is not affected. When an older adult or elderly adult is injured, recovery takes longer, so aging individuals often become fearful of the possible prolonged pain of injury. This makes older individuals risk averse. Risk aversion is the paramount catalyst in many diseases of aging, such as osteoporosis. First, it is important to understand injury, and how differences in recovery functions depend on the age of the individual.

For the sake of simplicity the term “injury” will be used in a broad sense, denoting a range of potential temporarily debilitating problems, from an event resulting in joint pain to severe non-head injury trauma that one is capable of recovering from. In 1999, the British Medical Bulletin published findings by Drs. Michael Horan and John Clague, called Injury in the Aging: Recovery and Rehabilitation. Their paper details variables that exist in recovery of traumatic injury. The three components of injury recovery are, first the return to function of injured body parts. Second, the general process of restoration from the deficits the overall body has from allocation of body resources to the injured area. Thirdly, the psychosocial adjustments of the individual, meaning both psychological state after the injury incident as well as social interactions that relate to the injury.

Other variables that become more prevalent with age are the presence of pre-existing diseases, impairments, medications, or even poor nutrition. All of these components become more complex as an individual gets older. Primarily, the return to function is longer because resources to be used in recovery are scarcer and the body has less ability to replenish resources after the return to function. The dominant effect is the psychosocial component. The older the individual, the less the social pressure to physically perform activities of daily living. Knowing this reduces the older individual’s confidence.

An examination of risk aversion from the time of childhood shows that an individual learns subconscious lessons from actions and reactions, through normal movement and trial and error, even before he or she has a conscious first memory. A young child who is just beginning to walk lacks coordination and balance so falls as he or she attempts to walk too quickly. The attempts to do something physical beyond what he or she has done before results in pain, which is the seed of risk aversion from both a subconscious and conscious knowledge of the results of actions.  While the experience of falling gives a child a psychosocial physical awareness making the child more cautious, the child is expected to walk and eventually run, therefore the child will be less affected by risk aversion.

A downward spiral in health can occur as a result of building aversion to risk, contributing to less physical activity over time. Loading of bone is the primary catalyst to stimulating growth in density, and this can only be achieved by engaging in axial loading of bone through physical activity. Exercise interventions are on the horizon that will better address this problem.



Horan, M. Clague, J. (1999). “Injury in the Aging: Recovery and Rehabilitation” British Medical Bulletin, 55 (4): 895-909



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