A shrinking man goes to his doctor in dismay. He wails, “Doctor! Doctor! I’m getting smaller and smaller and smaller!!!” His doctor replies, “Now, now, I can’t fix things right away—you’ll just have to be a little patient.”
Old (bad) jokes aside, the propensity to shrink with age, also known as “shrinkage,” is a common phenomenon—and one that may bring with it a fair amount of distress. After all, no one really wants to shrink, even if they are in good company. Once you reach age 40 or 50, it’s not unusual to lose about ¼ to ½ inch every 10 years, with the loss often accelerating after age 70.
Research from the Baltimore Longitudinal Study of Aging, for instance, found that women lost 2 inches between the ages of 30 and 70, and men lost a little more than an inch. By age 80, they lost about 3 inches and 2 inches, respectively. But these are averages, which obscure wide variability among individuals. Some people lose more than an inch in just one decade, while others start losing some height only after age 60 or 70. A lucky few don’t shrink at all.
Getting shorter might hurt your ego—but it could also have some health implications. People who lose more inches are more prone to ill health as they age. So, if your children and grandchildren are seeming taller in comparison to you these days, and your shirts are hanging longer than usual, here’s what to know about “shrinkage.”
Why do we shrink?
Over time, the spongy, fluid-filled discs between your vertebrae tend to lose water and flatten, shortening your spine. If you have osteoporosis, characterized by low bone density, you can develop compression fractures in your vertebrae, which not only decreases the height of the affected vertebrae but also causes the spine to curve more. And if your torso and core muscle are weak, that can further contribute to a stooped posture. Progression of scoliosis or kyphosis, types of spinal misalignment, can also shave inches off your height.
Women tend to shrink more than men, one reason being that they’re more likely to develop osteoporotic vertebral fractures in the wake of menopausal hormone changes. Women may also be more prone to disc degeneration, some research suggests.
Shorter stature = worse health?
While it’s normal to shrink some with age, a loss of two inches or more could be a warning sign that you have had one or more osteoporotic fractures (some of which may cause little or no pain). A significant loss of height could also indicate poorer health overall. Studies have linked excess height loss to an increased risk for fractures anywhere (not just in the spine), cardiovascular disease, and premature death in older adults.
A 2020 Indonesia study of people ages 45 and older, published in Economics & Human Biology, linked greater height shrinkage to worse physical health (including worse lung function and grip strength) and worse cognitive health late in life. The association remained even after the researchers accounted for the participants’ baseline health and socioeconomic status.
In an earlier Archives of Internal Medicine study from England, 60- to 79-year-old men who had lost 1.2 inches or more over the previous 20 years were much more likely to die over that period than men who lost less than 0.4 inches. Many of the “excess” deaths among the 4,213 participants in total were from heart or lung disease. Men who lost the most height also had other markers of poor health, such as inactivity, arthritis, weight loss, and difficulty walking.
And in a population of Japanese people in their 40s and older, those who lost even just 0.2 inches over a two-year period were at increased risk of dying from all causes, and from cardiovascular disease specifically, according to a 2023 study in Scientific Reports.
How might height loss affect health? One possibility is that shrinkage from compression fractures in the upper thoracic spine compresses the lungs and so may compromise pulmonary function, which then can affect cardiac function. Some researchers also speculate that, in severe cases, shrinkage puts pressure on the abdominal cavity, causing early satiety (feeling of fullness when eating) and subsequent nutritional deficits and weight loss. Height loss is also linked to progressive and generalized loss of skeletal muscle mass and strength, a condition called sarcopenia. This, in turn, is associated with weight loss and premature death.
Standing tall
When you have your annual health exam, you should have your height measured and compared to previous measures. And if you’ve noticed height loss on your own—especially if you have chronic back pain that may be related to it—you should tell your healthcare provider.
Weight-bearing exercise like walking, jogging, and stair climbing, along with resistance training with weights or bands, strengthens bones so they are less likely to fracture. Researchers still haven’t determined whether regular workouts prevent the adverse health effects linked to shrinkage, but exercise is beneficial in so many ways that it’s always worth doing.
A healthy, balanced, nutrient-rich diet that includes adequate calcium and vitamin D can also help you maintain bone density. You can get calcium from foods like yogurt (and other dairy products), canned sardines, tofu, beans and lentils, and fortified products. If you can’t get enough in your diet, calcium and vitamin D supplements can make up for shortfalls. Avoid heavy alcohol consumption and smoking—these behaviors affect bone remodeling, thereby reducing bone density and increasing the risk for osteoporosis.
A bone density scan provides information about the health of your bones. You should be tested if you’re a woman 65 or older or earlier if you’re at higher risk for osteoporosis—for example, because you have experienced fractures without significant trauma or went through early menopause (before age 45). Recommendations vary for men: The Endocrine Society advises screening for men 70 or older (and earlier if there are risk factors); other organizations recommend universal screening for men at age 75. If your bone density is low, taking an osteoporosis medication can improve bone mineral density and prevent fractures and thus further shrinkage.
BOTTOM LINE: Genetics play a large role in how much shrinkage is in your future, and, unfortunately, there’s nothing you can do about that. Same goes for things you did—or didn’t do—in your past, such as how much bone you built when you were young. But you may be able to slow the process by incorporating some healthy changes into your daily life, as discussed above. Such lifestyle practices are good for you, overall, even if they don’t stop the shrinkage as much as you might hope.
