DEAR DR. ROACH: I recently read that a large percentage of orthopedic injury to the elderly is directly related to their falling while walking large animals, specifically dogs over 20 pounds. Can you shed light on this please? — M.F.

ANSWER: A March 2019 study in JAMA Surgery did identify dog walking as an increasing cause of fracture. Over 4,000 fractures were identified among dog walkers over 65 in 2017, about triple the number 10 years earlier. However, this wasn’t a large proportion of fractures (only about 2 percent of total fractures), and the authors did not identify the size of the dog as a risk factor, although they did suggest that clinicians recommend a smaller (and well-trained) dog as a wiser choice.

Dogs not only provide some social support, they also encourage exercise. I have had many patients (and a few family members) who have very meaningful connections with their dogs and other animals. In fact, I have seen many people who describe their animal companions as the most important relationship in their lives.

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DEAR DR. ROACH: I am scheduled for a hip replacement operation because X-rays show joint failure. I am 81 years old and in excellent health. At the moment I do not feel any pain in my hip and am walking very easily. I go swimming three times a week. My question is whether I should agree to this operation as a preventive method to avoid later painful and possibly riskier circumstances because of my age. — P.H.

ANSWER: Hip replacement is indicated in people with severe, debilitating symptoms (such as pain or loss of function) despite conservative management. That doesn’t sound remotely like what you are describing. The findings on the X-ray are less important than your symptoms and function, so I could not recommend a hip replacement for you at this time. Age by itself is not a contraindication for hip replacement should you need one later on.

I do understand what you are saying: You are less likely to have a surgical problem being operated on earlier. Some surgeons will operate on people with milder symptoms for this reason. However, you aren’t describing even mild symptoms, hence my recommendation against surgery at this time.

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DEAR DR. ROACH: Just wondering about good versus bad cooking oils. At one time, coconut oil was said to be a bad oil, but now I’m reading that it’s really a good oil. Some even say you should eat a spoonful each day to boost your health! So, which is it? Is coconut oil good or bad? — J.Z.

ANSWER: Coconut oil is “bad,” at least compared with healthier oils like olive oil and canola oil. It has a high saturated fat content, and people who consume coconut oil have an increase in their total cholesterol and unhealthy LDL cholesterol. If you love the taste of coconut oil, it’s reasonable in moderation, but don’t consume it thinking it is good for your health or your heart. The available evidence does not support that.

Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

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