Which of the following decreases in elderly patients?

• A. Bone mass
• B. Muscle mass
• C. Vertebral height
• D. All of the above

Answer: (D)

As people age, multiple tissues experience decline, so bone density, muscle mass, and vertebral height all tend to decrease. Bone mass drops because the balance between bone resorption and formation shifts toward resorption, especially after menopause in many individuals, leading to lower bone mineral density and a higher fracture risk. Muscle mass declines through sarcopenia, a process that involves loss of muscle fibers and motor units, changes in muscle metabolism, and reduced physical activity, resulting in weaker, smaller muscles. Vertebral height decreases because of osteoporosis-related compression fractures and wedge deformities, along with degenerative changes in the spine, which shorten the vertebral bodies and reduce overall height.

Putting these together, the elderly commonly show reductions in bone density, muscle mass, and vertebral height, making all of the listed changes occur with aging.