Do you shrink as you get older?

Memories, vision and hearing are some of the few things that tend to disappear as the number of candles on our birthday cakes increase. Unfortunately, height and weight are also on the list of things that change as we age. Research shows that shrinking begins as early as our 30s, such that between the ages of 30 to 70 years, men tend to lose an inch whilst women within that age lose about 2 inches. Above the age of 80, it is possible for men and women to lose another inch as they grow older.¹⁰ Apart from a sign of normal aging, a reduction in height may also be the result of an underlying medical condition. Those who lose one to two-inch within a year might be at risk of some underlying factors like heart disease. 

Overview

After we are born, we get taller, and after a peak period in height, ageing causes a decrease in height, which in turn causes us to get shorter. One reason for this can be due to several determinants that affect the spine.²

The cartilage pads between the joint in the leg and spine gradually wear away as age increases.  Osteoporosis can also cause the vertebrae to shrink slightly.⁵ Spinal discs that sit between the vertebrae of the spine act as shock absorbers, and aid in keeping the back flexible during movement. When we are born, these spinal discs are composed of about 80% of water, and as we grow older, they tend to lose fluid due to compression, wear and tear. This causes these discs to flatten out, thereby making the spaces between the trunk and spine shorter.⁸

Most people at the age of 60 suffer disc degeneration, which can result in men losing about 3cm after this age and women losing 5cm. Although changes in our spinal discs is not the only factor causes a change in height as we age. Factors like sarcopenia (i.e loss of muscle mass and strength) can cause 3 to 5% of muscle mass loss each decade. This can cause a weakening of our torso muscle, which is solely responsible for keeping us upright, and in turn can cause a stooped posture, thereby making an individual look shorter.¹

Can you shrink with age?

Shrinking occurs as you age and is caused by several different factors. Although it is normal to shrink as you age due to structural changes in the body, osteoporosis is another major factor which causes shrinking in individuals.

Osteoporosis

According to the NHS, osteoporosis is a health condition that weakens the bone, making them fragile and more susceptible to breaking. Osteoporosis develops slowly over several years and is typically diagnosed after a fall or impact that caused the bone to fracture. Osteoporosis is often called a ‘silent disease’ as it is not noticeable until a bone breaks.^{3, 11} Commonly observed fractured/broken bones include the hip, wrist, and spine, which are always painful.

Osteoporosis causes greater loss in bone mass than normal. Typically around the age of 35, bone breakdown occurs quicker than bone buildup and in women who enter menopause, bone breakdown occurs even quicker than in men.⁹

An in-depth look at the inside of the bone shows an image like a bee’s honeycomb. When an individual has osteoporosis, the spaces in this honeycomb grow larger, and the bone that forms the honeycomb gets smaller. The outer covering of the bones also gets thinner. All of this makes the bones weaker.⁶

Risk Factors of Osteoporosis

• Having a small body frame
• Smoking 
• Having a family history of osteoporosis
• Having a bone fracture after age 50
• Having surgery to remove ovaries before period stops
• Calcium or vitamin D deficiency throughout the growing period
• Development of early menopause
• Use of certain medications for arthritis, asthma, and cancer
• Physical inactivity/extended bed rest

Bone density

Low bone density, also referred to as osteopenia, is a condition that causes bone mineral density to decline, thereby causing fractures. Not everyone with low bone mineral density will develop osteoporosis but it is possible to develop osteoporosis as a result of low bone density.⁴

Osteoporosis is common in individuals above 50 years old, people with poor nutrition, and women after menopause.

Bone density is measured with a quick and painless imaging test called ‘dual-energy x-ray absorptiometry’. The bone density test provides a score called the T-score.

• +1 to –1 indicates normal bone density.
• –1 to –2.5 indicates osteopenia.
• –2.5 or lower means osteoporosis.

Sarcopenia 

According to Santilli, sarcopenia is a condition characterised by loss of skeletal muscle mass and function. It is a disease that is primarily concerned with the elderly, however, it can also be seen in younger people with inflammatory disease.³ Its development has been associated with conditions seen in elderly people like malnutrition and muscle wasting. The consequences of sarcopenia are often severe in older adults as the strength and functional declines associated with sarcopenia can in turn contribute to a number of adverse health outcomes, including loss of function, disability, and frailty.^1,4,9 Sarcopenia is likewise associated with chronic and acute conditions like increased falls, insulin resistance, tiredness, and death.⁷

How to Avoid Shrinking

Diet and lifestyle modifications are the factors that can be controlled to avoid shrinking, such that diets rich in calcium and physical exercise can go a long way in preventing shrinking. Risk factors like alcohol intake and smoking are suggested to be avoided. Doctors suggest at least 1,200mg of calcium a day, as regular intake of this amount can prevent bone loss. Strength exercises are also encouraged to help strengthen bones and increase muscle mass.

Treatments for Osteoporosis

Osteoporosis can be treated through a number of ways, including:^{7, 5}

1. Physical activity: no matter the form of the exercise, physical exercise helps to strengthen the bone and helps to reduce age-related bone loss. Exercise can also help improve posture and balance. Jogging, biking, and walking are good examples of exercises that are encouraged for the elderly.
2. Use of minerals and vitamin supplements 
3. Calcium and vitamin D supplements
4. Use of medications

• Medications like hormones and hormone-related therapy
• Bisphosphonates
• Biologics
• Anabolic agents

When to Seek Medical Advice

It is important to seek medical advice as soon as symptoms arise because fractures can be life-changing. Women are encouraged to start bone density screen immediately after they enter menopausal age (mid to late 40s) while men are to begin screening at the age of 60 years old. Bone density evaluations are also encouraged if an individual has broken/fractured a bone as an adult.

Summary

It is indeed possible to shrink as you age due to structural changes in the body. Factors such as osteoporosis and sarcopenia can make an individual lose more inches than usual. These conditions are typically triggered by insufficient intake of calcium and vitamin D, as well as consumption of alcohol and smoking.

Physical activities, such as weight bearing, jogging, and walking, are encouraged in adults. It is necessary to seek medical advice when a fracture has occurred. Women who are in their mid or late 40s are also encouraged to carry out regular bone density test as development of early menopause is a risk factor for osteoporosis.

Shrinking due to age is completely normal but losing more inches than usual requires immediate attention, as this can be a sign of an underlying disorder.