Risk factors

The rate of hip fractures increases substantially with:

• Age. Bone density and muscle mass tend to decrease with age. Older people can also have problems with vision and balance, which can increase the risk of falling.
• Your sex. Hip fractures occur in women about three times more often than they do in men. Women lose bone density faster than men do, in part because the drop in estrogen levels that occurs with menopause accelerates bone loss. However, men also can develop dangerously low levels of bone density.
• Osteoporosis. If you have this condition, which causes bones to weaken, you're at increased risk of fractures.

• Other chronic medical conditions. Endocrine disorders, such as an overactive thyroid, can lead to fragile bones. Intestinal disorders, which can reduce your absorption of vitamin D and calcium, also can lead to weakened bones.

  Medical conditions that affect the brain and nervous system, including cognitive impairment, dementia, Parkinson's disease, stroke and peripheral neuropathy, also increase the risk of falling.

  Having low blood sugar and low blood pressure also can contribute to the risk of falls.

• Certain medications. Cortisone medications, such as prednisone, can weaken bone if you take them long-term. Certain drugs or certain combinations of medications can make you dizzy and more prone to falling. Drugs that act on your central nervous system — such as sleep medications, antipsychotics and sedatives — are most commonly associated with falls.
• Nutritional problems. Lack of calcium and vitamin D in your diet when you're young lowers your peak bone mass and increases your risk of fracture later in life. It's also important to get enough calcium and vitamin D in older age to try to maintain the bone you have. As you age, try to maintain a healthy weight. Being underweight increases the risk of bone loss.
• Physical inactivity. Lack of regular weight-bearing exercise, such as walking, can result in weakened bones and muscles, making falls and fractures more likely.
• Tobacco and alcohol use. Both can interfere with the normal processes of bone building and maintenance, resulting in bone loss.