Bone Health In Older Adults (Credit-Canva)
Strengthening your bones is not something that can happen overnight, it takes years for your body to build strong bones and even then, it is natural for them to lose their dexterity. All you can do is keep your body healthy to make sure it is prepared for any unexpected situations. For years, many older adults have been told to take vitamin D and calcium supplements to keep their bones strong and prevent falls. However, a new report from U.S. Preventive Services Task Force (USPSTF) is changing that advice. This report suggests that for most older people, these supplements don't actually prevent falls or broken bones. This might be surprising news, we must understand why falls happen more often as we age, what vitamin D and calcium do in the body, and most importantly, what you can do to stay safe and prevent fractures.
According to the report, vitamin D supplements don't seem to help prevent falls or broken bones for most people over 60. They also found that these supplements, especially with calcium, might increase the risk of kidney stones. This report doesn't mean people with weak bones (osteoporosis), low vitamin D, or who take vitamin D for other health reasons shouldn't take it. It just means that for most healthy older people, these supplements don't prevent falls and fractures.
There are many reasons why older people are more prone to breaking their bones. Our bones are strongest when we're in our 20s and 30s, and they get weaker as we age so naturally, they can break easily. It can also be harder to move around as we get older, sometimes because of problems like arthritis this can affect how we walk and make us less steady.
There are also different issues like neuropathy, which is a nerve problem that can also make it harder to feel your feet and keep your balance. Eyesight is also a culprit as it can cause you to feel dizzy and fall. Some medicines can also make people feel unsteady, and older people often take more medicines than younger people. Low vitamin D itself can also increase the risk of falls, so keeping vitamin D levels up is still important.
USPSTF recommends a few better ways to protect your bone health and prevent broken bones and falls.
Regular walks strengthen your muscles and bones, which helps you stay steady on your feet. It is as simple as practice makes perfect so the more you walk, the better it is. Walking also improves your balance, making you less likely to fall.
Strength training, like lifting weights or using resistance bands, makes your bones stronger and helps prevent fractures if you do fall. It is like a safety cushion, but you must be careful while doing so because it can lead to injuries if done too much.
Activities like tai chi, Pilates, and yoga can improve your balance and coordination, making you more stable and less prone to falls. These can also help you improve your muscle flexibility and strength that in turn helps your body be stronger.
If you have osteoporosis, talk to your doctor about medications that can help strengthen your bones and lower your risk of fractures. Many medications can also have unsavory side effects like weakened joints, losing muscle strength, etc.
A proper diet goes a long way when it comes to your entire body health. So to keep up with your body’s nutrition and muscle health, eat more protein along with a balanced meal that includes loads of fiber, healthy fats and carbs.
Having poor eyesight can be difficult, not only does it make life difficult without glasses, but it also increases the possibilities of getting into minor accidents like bumping into people and missing objects placed in front of us.
Getting enough sleep is also important because when you are not sleeping, you get disoriented and can ignore even obvious things like the last stair in the staircase. Make sure you get enough sleep to keep you fresh and focused.
There are many things that can cause you to have accidents, even in your home. To avoid such falls, make sure there are no lose ends like crooked floor panels, rugs that are sticking out or protruding furniture that can hurt your knees
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Menopause is gradually finding its well-deserved place in mainstream media. For the first time in a dozen years, the American College of Obstetricians and Gynecologists (ACOG) has revised its clinical guidance on treating key menopause symptoms like including hot flashes, night sweats, sleep disturbances and mood swings.
The new guidance, released in October 2026, talks about hormone therapy as the most effective treatment for moderate to severe hot flashes.
It also highlights non-hormonal options like cognitive behavioural therapy, mindfulness and clinical hypnosis for women who do not want to opt for hormone therapy.
The update comes after certain boxed safety warnings on hormone-based products were removed by the US Food and Drug Administration (FDA).
Also read: Beyond “Just Ageing”: Why Menopause Deserves a Place in India’s Mainstream Healthcare Conversation
Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms, which include hot flashes and night sweats. These symptoms occur as changing hormone levels affect the body's temperature.
ACOG recommends systemic hormone therapy containing oestrogen and a progestogen for women with a uterus. Women who do not need endometrial protection may receive oestrogen alone.
The guidance also suggests considering hormone therapy for sleep disturbances, which is also one of the vasomotor symptoms.
However, hormone therapy may not be a viable option for everyone. Decisions should be made jointly by patients and their doctors, which may be taken after taking into account age, medical history, cardiovascular disease risk, breast cancer risk and the risk of venous thromboembolism, or blood clots.
ACOG also recommends starting treatment before the age of 60 or within 10 years of the onset of natural menopause for.
Women who cannot take hormone therapy have several other non-hormonal options. ACOG recommends selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), which are antidepressant medicines that can also help manage hot flashes.
Another option is neurokinin receptor antagonists. These medicines act on pathways involved in regulating body temperature and can reduce hot flashes and night sweats. Fezolinetant and elinzanetant are examples of medicines in this category.
Gabapentin may also be considered when other non-hormonal medicines are ineffective .
The updated guidance also recognises lifestyle and behavioural changes for managing menopause symptoms. ACOG suggests cognitive behavioural therapy (CBT) to help with hot flashes, sleep disturbances and mood symptoms.
Mindfulness-based interventions and physical exercise may help improve sleep and mood, while clinical hypnosis may reduce hot flashes and improve sleep and anxiety symptoms.
Acupuncture is also an option that may help tackle vasomotor symptoms and improve sleep and mood.
These alternative options can be used alone or alongside medication, depending on a woman's symptoms and treatment preferences.
Menopause can affect several aspects of health and daily life. Hot flashes and night sweats can disrupt sleep, while mood changes and other symptoms may affect work, relationships and overall quality of life.
For a long time, concerns about the risks of hormone therapy have influenced how patients and doctors approach treatment.
The new guidance reinforces that hormone therapy remains an effective option for many women, while stressing the importance of individual risk assessment and preference.
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When we think of perimenopause, irregular periods, hot flashes and mood changes usually come to mind. But the transition to menopause is not limited to the menstrual cycle. Behind the scenes, changing ovarian hormones—particularly fluctuating and eventually declining estrogen—can influence body composition, insulin sensitivity, cholesterol levels, bone health and cardiovascular risk.
For many women, these metabolic changes begin years before their final menstrual period.
A common concern during perimenopause is: “I haven’t changed my diet, so why am I gaining weight around my abdomen?”
Ageing itself contributes to gradual loss of muscle mass and changes in energy expenditure. At the same time, the menopausal transition is associated with a shift in fat distribution, with a greater tendency to accumulate visceral or abdominal fat.
This matters because visceral fat is metabolically active. An increase in abdominal fat can be associated with insulin resistance, abnormal cholesterol levels and a higher risk of metabolic disease. So, the change in waist circumference may sometimes tell us more about metabolic health than the number on the weighing scale alone.
Also read: After Menopause, These Breast Changes Shouldn’t Be Ignored
Estrogen interacts with several pathways involved in glucose and fat metabolism. During midlife, changes in body composition, reduced physical activity, sleep disturbance and hormonal changes can collectively make insulin sensitivity less favourable.
This does not mean every woman going through perimenopause will develop diabetes. However, women who already have risk factors—such as overweight or obesity, prediabetes, a history of gestational diabetes or a strong family history of type 2 diabetes—should be particularly mindful.
The menopausal transition can also be accompanied by unfavourable changes in the lipid profile, including changes in LDL cholesterol. Cardiovascular risk increases with age, and menopause is an important time to reassess risk factors such as blood pressure, glucose, cholesterol, smoking, physical activity and body composition.
Women often spend years focusing on reproductive health while overlooking these equally important metabolic markers.
Also read: World Menopause Day: Is It Empty Nest Syndrome Or Menopause Symptoms? Expert Explains
Midlife is also an important period for protecting muscle and bone. Declining estrogen after menopause accelerates bone loss, while ageing contributes to loss of muscle mass.
Resistance training therefore becomes especially valuable. Adequate protein intake, regular weight-bearing exercise, sufficient calcium and vitamin D, good sleep and avoiding smoking can support healthier ageing.
Perimenopause should not be viewed as a disease, nor should every symptom or kilogram gained in midlife automatically be blamed on hormones. Instead, it is an opportunity for a metabolic health check.
Women should discuss appropriate screening for blood pressure, blood glucose or HbA1c, lipid profile, weight and waist circumference monitoring , DEXA scan for bone health, depending on their individual risk factors.
Most importantly, don’t wait for menopause to start thinking about metabolic health. The perimenopausal years can be an important window to build muscle, improve fitness, optimise nutrition and identify metabolic risk early.
Perimenopause is more than a change in periods—it is a transition in whole-body health. Understanding these changes early can help women enter the next phase of life stronger, healthier and better prepared.
(By Dr. Seema Daksh, MBBS, MD (Internal Medicine), DM (Endocrinology), Consultant Endocrinologist,Kailash Hospital, Greater Noida)
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Loud habitual snoring is often dismissed as a nuisance or simply a part of sleeping. For some people, it may be an early warning sign of obstructive sleep apnoea, a condition in which breathing repeatedly slows or stops during sleep. When left unaddressed, sleep apnoea can quietly strain the heart and blood vessels, increasing the risk of blood pressure, irregular heart rhythms, heart attack and stroke.
Snoring happens when relaxed tissues in the throat vibrate as air moves through a narrowed airway. Not everyone who snores has a problem and occasional snoring is common. However loud and regular snoring, especially when a bed partner notices pauses in breathing, choking or gasping should not be ignored. It may indicate sleep apnoea, where the airway collapses repeatedly during sleep.
Each time breathing stops, oxygen levels drop. The brain briefly wakes the body up to restart breathing. Most people do not remember these interruptions but their body feels the effects. Over time, this cycle can disturb sleep, raise blood pressure, increase inflammation and put pressure on the cardiovascular system.
Also read: ‘Godzilla’ Drug Retatrutide Reverses Sleep Apnea In 1 In 4 Diabetes Patients
Sleep apnoea is increasingly recognised as a risk factor for stroke. It can worsen hypertension. Contribute to atrial fibrillation, an irregular heartbeat that raises the likelihood of a stroke. The concern becomes greater in people who already have conditions such as diabetes, obesity, high cholesterol or a family history of heart disease.
For them, untreated sleep apnoea may add to the strain on the heart and blood vessels. A landmark study by the All India Institute of Medical Sciences (AIIMS) New Delhi estimates that roughly 104 million Indians suffer from Obstructive Sleep Apnea (OSA), with about 47 million cases classified as moderate to severe.
There are also signs that should prompt a conversation with a doctor. Waking up unrefreshed despite spending hours in bed, feeling excessively sleepy during the day, experiencing morning headaches, and struggling to concentrate or becoming unusually irritable can all be linked to poor-quality sleep caused by sleep apnoea. If snoring is accompanied by any of these symptoms a sleep study may be recommended to confirm whether it is snoring or a more serious breathing disorder.
The reassuring part is that sleep apnoea is treatable. Depending on its cause and severity, doctors may suggest weight management where relevant, avoiding alcohol and sedatives close to bedtime, treating congestion, changing sleep position, using an oral appliance or undergoing CPAP therapy, which keeps the airway open during sleep.
The message is not to worry about every snore but to take loud snoring seriously particularly when it comes with breathing pauses or daytime tiredness. Early diagnosis can improve sleep, energy and overall quality of life while helping reduce long-term risks to the heart and the brain.
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