What two risk factors increase the likelihood of vertebral compression fracture in older adults?

What two risk factors increase the likelihood of vertebral compression fracture in older adults?

• A. Age over 50 and sedentary lifestyle.
• B. Female sex and obesity.
• C. Age over 65 and history of osteoporosis or long-term systemic corticosteroid use.
• D. Regular exercise and calcium supplementation.

Answer: (C)

Fragility fractures of the spine happen when bones are weakened, so the two main drivers are low bone density and factors that actively worsen bone loss. Age over 65 signals natural, age-related decline in bone density, making fractures more likely. When someone has osteoporosis or is on long-term systemic corticosteroids, their bones become even more fragile—corticosteroids reduce bone formation and increase bone loss—greatly increasing the risk of vertebral compression fractures. The combination of being older and having osteoporosis or steroid-induced osteoporosis best captures the risk. Other options touch on contributors that are less direct (like sedentary behavior) or describe protective factors (like exercise or calcium) rather than true risk enhancements.