Losing Height After 50: How Much Matters and When to Ask About Your Spine

Plenty of women notice they’ve shrunk a little by their 60s. Sometimes that’s ordinary. Sometimes it’s the only sign of a spine fracture that never hurt. The Bone Health and Osteoporosis Foundation (BHOF)¹ warns that most vertebral (spine) fractures cause no symptoms and “may go undiagnosed for many years.”

The two numbers that matter

How you measure it	The line in US bone guidelines
Compared with your peak height as a young adult	1.5 inches (about 4 cm) or more1
Compared with your last measured height	0.8 inches (about 2 cm) or more1

For women past menopause, either one is a reason to consider a bone density test and an X-ray or scan of the spine to look for hidden fractures.¹ If you’re already being followed for bone loss, the same losses are a reason to repeat spine imaging.¹

Measure it properly

• Once a year, shoes off, against a wall-mounted measure. The BHOF says wall-mounted measures are more reliable than freestanding ones.¹
• Know your starting point. Your height on an old driver’s license or from your 20s gives your clinician a peak to compare against.

Height loss carries its own risk

In a US study of 3,124 women aged 65 and older, height was measured about 15 years apart. Women who lost more than 2 inches (5 cm) had about a 50% higher risk of hip fracture, other fractures and death, even after accounting for spine fractures and bone density.² It’s an observational study, so it shows a link, not a cause.²

Other clues to mention

• A new stoop, or back pain with no clear cause, are reasons to look for new spine fractures.¹
• Several spine fractures can do more than bend your posture. Fractures in the upper back can restrict breathing, and fractures in the lower back can cause constipation, belly pain, early fullness and weight loss.¹
• Any broken bone after 50, whatever the cause, should be checked for osteoporosis.¹

What helps

• Get the right tests. See T-score vs Z-score, the FRAX bone health checklist and bone density scan coverage.
• Strength training can be safe and helpful. In the LIFTMOR trial, supervised high-intensity training in women around 65 with low bone density reduced the stoop without raising spine fracture risk.¹ See the LIFTMOR trial.

Try: “I used to be 5 foot 6, and today I measured 5 foot 4 and a half. Should I have a bone density test, and should we image my spine to look for fractures?”

My Body Changed. Now What? lists height loss or a new stoop as a reason to ask about bone health, alongside a fracture after a minor fall. Add your young-adult height and today’s height to your Visit Brief, with any family history of hip fracture. See the book.