Research from Spain confirms that senior women are three times more likely than their male peers to fracture a hip but also finds risk factors differ for men and women. Illiteracy and depression increase the risks of fracture for senior women, while smoking and disability raise the risk for senior men. Dementia doesn’t increase the risk of hip fractures, but being married or having a partner does reduce the risk for men and women, say the authors. Each year, more than 300,000 Americans over the age of 65 are hospitalized for hip fractures, according to the Centers for Disease Control and Prevention. About three out of four hip fractures occur in women.

The study, published in Maturitas, was led by Elena Lobo of the Department of Preventive Medicine and Public Health at Zaragoza University in Spain. Lobo and colleagues analyzed medical and psychiatric histories for 4,803 adults in Zaragoza over the age of 55, including the number of hip fractures. Participants were 73 years old, on average. Over the course of 16 years, about eight percent of women broke a hip, compared to less than three percent of men. Among the women in the study, being unable to read increased the risk of hip fracture by about 50 percent and being diagnosed with depression increased the risk by 44 percent. For the men, smoking doubled the risk of hip fracture and being disabled tripled the risk. Men who were coupled were half as likely to suffer a hip fracture and women who were married or lived with someone were 30 percent less likely to break a hip. The authors of the study said this finding also makes sense because seniors who live with a partner are less likely to be malnourished or depressed and more likely to have support with a possible disability. The authors also reinforced the importance to make sure that older adults are consuming an adequate number of calories. Their diet should focus on calcium and protein rich foods to prevention bone and muscle mass loss.