Age-specific Incidence Of Hip Fractures Research Articles

Incidence of four major osteoporotic fragility fractures among older individuals in Sado, Japan, in 2020.

This study compared the 2020 incidence of fragility fractures in Sado City with those from 2004 to 2015. Data from patients aged ≥ 60years living in Sado City with fragility fractures in the hip, vertebral, distal radius, and proximal humerus between January 1 and December 31, 2020, were collected. We examined the number and incidence of four types of osteoporotic fractures in the older population aged ≥ 60years living in Sado City in 2020. We compared the results with those of the 2004, 2010, and 2015 surveys, examining the temporal change and trend in the incidence of the four fracture types in this population. We investigated the use rate of anti-osteoporotic medications and the relationship between their administration and the occurrence of fragility fractures. The age-specific incidence of hip fractures slightly decreased from 2015. However, the incidence of the other three fractures slightly increased, although the difference was not statistically significant. The incidence of hip fractures markedly increased in the 80s. In 2020, the percentage of patients taking anti-osteoporotic agents before the occurrence of fractures decreased to 12.4% from 14.5% in 2015; it increased from 4% in 2004 to 7.6% in 2010. The 2020 incidence of the four fractures did not decrease, and the percentage of patients receiving anti-osteoporotic agents did not increase. A higher frequency of osteoporosis treatment is necessary to reduce the incidence of fragility fractures. We recommend using anti-osteoporotic agents to prevent hip fractures among individuals in their mid-70s and above.

Declining incidence trends for hip fractures have not been accompanied by improvements in lifetime risk or post-fracture survival – A nationwide study of the Swedish population 60 years and older

BackgroundHip fracture is a common cause of disability and mortality among the elderly. Declining incidence trends have been observed in Sweden. Still, this condition remains a significant public health problem since Sweden has one of the highest incidences worldwide. Yet, no Swedish lifetime risk or survival trends have been presented. By examining how hip fracture incidence, post-fracture survival, as well as lifetime risk have developed between 1995 and 2010 in Sweden, this study aims to establish how the burden hip fractures pose on the elderly changed over time, in order to inform initiatives for improvements of their health. Material and MethodsThe entire Swedish population 60years-old and above was followed between 1987 and 2010 in the National Patient Register and the Cause of Death Register. Annual age-specific hip fracture cumulative incidence was estimated using hospital admissions for hip fractures. Three-month and one-year survival after the first hip fracture were also estimated. Period life table was used to assess lifetime risk of hip fractures occurring from age 60 and above, and the expected mean age of the first hip fracture. ResultsThe age-specific hip fracture incidence decreased between 1995 and 2010 in all ages up to 94years, on average by 1% per year. The lifetime risk remained almost stable, between 9% and 11% for men, and between 18% and 20% for women. The expected mean age of a first hip fracture increased by 2.5years for men and by 2.2years for women. No improvements over time were observed for the 3-month survival for men, while for women a 1% decrease per year was observed. The 1-year survival slightly increased over time for men (0.4% per year) while no improvement was observed for women. ConclusionsThe age-specific hip fracture incidence has decreased over time. Yet the lifetime risk of a hip fracture has not decreased because life expectancy in the population has increased in parallel. Overall, survival after hip fracture has not improved.

Incidence of hip fracture in Niigata, Japan in 2004 and 2010 and the long-term trends from 1985 to 2010.

We investigated the incidence of hip fracture in a population of patients ≥50 years old in 2004 and 2010 in Niigata City, Niigata Prefecture, Japan. We also investigated the long-term trends in the incidence of hip fracture from 1985 to 2010, using our previously reported survey results obtained from 1985 to 1999. In 2004 and 2010, the survey found 2,368 and 3,218 proximal femur fractures, respectively. The crude hip fracture incidence rates in 2004 and 2010 were 215.8 and 281.5 per 100,000 of population per year, respectively. For males, the incidence rates were 99.9 in 2004 and 126.3 in 2010; for females, the incidence rates were 311.0 and 410.7, respectively. In males aged 80-84 years, the incidence rate since 1999 has been decreasing, while that for males >85 years peaked in 2004. In females of all ages, the incidence rate was higher in 2010 than in all other survey periods, and in females >85 years, the incidence has increased the fastest. Additionally, the long-term changes in the age- and sex-standardized incidence each year using the 1985 population structure in Japan in females has been increasing, although it decreased in 1999. However, in males, the incidence in 2010 was not significantly different from that in 1994, although it has been increasing since 1999. Our study findings indicate that the age-specific incidence of hip fractures in the Niigata Prefecture of Japan has not plateaued in females, but that it may have done so in males; in addition, the number and incidence of hip fractures has been increasing.

Re: Trends in hip fracture incidence and mortality in Chinese population from Hong Kong 2001-09

Background: there is a suggestion that while the age-adjusted incidence of hip fracture in the West may be declining, the incidence may be rising in Asia. Objective: this study examines the incidence and post-fracture mortality from 2001 to 2009 among the population aged 65 years and over. Methods: hip fracture incidence rates and case-fatality rates among Hong Kong population aged 65 and over for the period 2001–09 were obtained from the Hong Kong Hospital Authority (HA) database. Rates were adjusted for age. Poisson and logistic regressions were used to examine trends in incidence and post-fracture mortality, respectively. Results: the age-adjusted incidence rate of hip fracture among the population aged 65 and over in Hong Kong (per 100,000 population) decreased from 381.6 for men and 853.3 for women in 2001 to 341.7 and 703.1, respectively, in 2009. There were no significant changes in post-fracture mortality trends. Conclusions: there is a downward trend in age-specific hip fracture incidence rates since 2001 among Hong Kong Chinese, but no change in post-fracture mortality trends.

Trends in hip fracture incidence and mortality in Chinese population from Hong Kong 2001-09

there is a suggestion that while the age-adjusted incidence of hip fracture in the West may be declining, the incidence may be rising in Asia. this study examines the incidence and post-fracture mortality from 2001 to 2009 among the population aged 65 years and over. hip fracture incidence rates and case-fatality rates among Hong Kong population aged 65 and over for the period 2001-09 were obtained from the Hong Kong Hospital Authority (HA) database. Rates were adjusted for age. Poisson and logistic regressions were used to examine trends in incidence and post-fracture mortality, respectively. the age-adjusted incidence rate of hip fracture among the population aged 65 and over in Hong Kong (per 100,000 population) decreased from 381.6 for men and 853.3 for women in 2001 to 341.7 and 703.1, respectively, in 2009. There were no significant changes in post-fracture mortality trends. there is a downward trend in age-specific hip fracture incidence rates since 2001 among Hong Kong Chinese, but no change in post-fracture mortality trends.

Incidence of HIP Fractures among the Elderly in Satakunta, Finland

The aim was to describe the incidence rate of hip fractures in the elderly in a specific region in Finland and circumstances around them. Retrospective analysis of 461 women and men aged 65 or older undergoing an operation for hip fracture during a two-year period between 1999 and 2000. 80 variables in all were obtained from the hospital discharge register and patient documents. The age-specific incidence of hip fractures was higher in women than in men (women 6.88/1000 person/y vs. 3.50/1000 person/y). Prior to the fracture, patients were primarily doing well; 63.4% lived at home and 65.1% used no mobility equipment or aids. Altogether 41.9% of hip fractures occurred in institutions. Both women and men more often suffered their injury indoors (91.1% and 75.7% respectively), and only a slight seasonal variation was observed. More than every fourth (26.9%) had experienced a previous fracture. The age-specific incidence of hip fractures was higher in women than in men. The fractures took place mostly indoors and often in institutions. Therefore the measures that impact on indoor safety are particularly important for the elderly.

Faible incidence des fractures de l’extrémité supérieure du fémur chez les patients de plus de 60 ans dans les îles de Guadeloupe

Purpose of the study The purpose of this study was to determine the incidence of hip fractures among the elderly population in Guadeloupe, a French Caribbean archipelago with 440,000 inhabitants who present two rarely associated characteristics: 90% of the population is of African descent and life expectancy is similar to that of European populations. Material and methods Using the recent census report, we established that in 2002, 61,000 persons aged 60 years or more (27,000 men and 34,000 women) lived in Guadeloupe. All new cases of hip fracture among the population aged 60 years or more were recorded in 2002, 2003, and 2004 in the seven islands that compose Guadeloupe. For each case, we noted patient age and gender, type of hip fracture, and treatment administered. We excluded open and pathologic fractures. Overall and age-specific incidence of hip fractures were determined and compared with rates reported for other countries. Results Three hundred and two new cases of hip fracture were recorded from 2002 to 2005 in 211 women (70%) and 91 men (30%). The age of patients was 82 years on average (range 60-102). There were 134 neck fractures and 168 intertrochanteric fractures which were treated by osteosynthesis for 193 and arthroplasty for 108. Only one orthopedic treatment was noted. The incidence of hip fracture for people aged over 60 years was 16.9/10,000; for the population aged 65 years or more, it was 22.2/10,000. Discussion Osteoporotic fracture is a pandemic problem. Incidence is increasing worldwide. Our findings demonstrate that Guadeloupeans are spared from this pathology. This population offers an interesting field for research into the causal mechanisms of osteoporotic fractures and potential means of prevention or screening. Conclusion The incidence of hip fractures among the elderly population in Guadeloupe is the lowest recorded in the world. We suggest that an environmental and genetic study in this spared population could provide interesting insight into the cause of hip fractures and appropriate means of prevention and screening among the elderly. The geographic and environmental characteristics of Guadeloupe make this area a unique zone of research and should enable new insight into the genetic and environmental factors involved in hip fractures.

Increased incidence of hip fractures. A population based-study in Finland

In Central Finland, the age-specific incidence of hip fractures did not change between the years 1982–1983 and 1992–1993 though the total number of hip fractures increased by 11% due to population aging. The objective of this study was to define the current hip fracture rates and the characteristics of patients with hip fracture. The population at risk consisted of 240,000 persons living in the Central Finland Health Care District. Hip fracture patients were identified by using the hospital discharge register, the operation lists, and the register of the Department of Anesthesiology. Patients' residential status, weight, and height, date and time of hip fracture, place of accident and mechanism and type of fracture were obtained from medical records. A total of 597 patients, 415 (69.5%) women and 182 (30.5%) men, were admitted to the hospital for treatment of an acute hip fracture in 2002–2003. The mean age of the patients was 79 (SD 13) years. Among patients aged ≥ 50 years ( n = 577), 80.8% of the hip fractures had occurred indoors, 97.6% with a low-energetic mechanism, and 22.7% during the nighttime. The ratio of trochanteric to cervical fractures was 2:3. Between 1992–1993 and 2002–2003, the total number of hip fractures increased by 70%, from 351 to 597. The fracture rates per 1000 person-years in the age group ≥ 55 years were 2.0 and 3.9 in 1992–1993 and 2.8 and 5.6 in 2002–2003 for men and women, respectively. The corresponding age-adjusted incidence rate ratio (IRR) for men was 1.36 (95% CI: 1.06 to 1.76), P = 0.017, and for women 1.25 (95% CI: 1.07 to 1.47), P = 0.006. Among men, the IRR was highest in the age group 75–84 years, IRR = 1.67 (95% CI: 1.08 to 2.65), while among women, it was highest in the age group ≥ 85 years, IRR = 1.33 (95% CI: 1.02 to 1.75). The total number of hip fractures almost doubled within 10 years, and the age-adjusted incidence rate increased in both sexes. The accretion of the hip fracture incidence was more than could be explained merely by changes in population size and structure.

Hip Fracture

Summary: Hip fracture incidence varies worldwide, with numerous factors, among them age, gender, race, reproductive history, hormonal status, race, institutionalization, medical comorbidities, hip geometry, medications, bone density, body habitus, diet, smoking, alcohol, fluoridation of water supplies, environment, climate, and osteopenia, all influencing risk. The independent manner in which these factors could affect the risk of hip fracture is becoming increasingly understood. However, the aging population and rising age-specific hip fracture incidence continue to contribute to an increasing global prevalence. Improved analysis and understanding of current hip fracture epidemiology and risk factors could facilitate enhanced prevention strategies to stem the rising prevalence.

Osteoporosis in Men

Hip fractures in men account for one third of all hip fractures and have a higher mortality than in women. The public health burden will increase as the increase in the numbers of elderly men in the community increases. In addition, the age-specific incidence of hip fractures may be increasing in some, but not all, countries. Vertebral fractures may be a public health problem as recent studies suggest that the prevalence in the community is 20-30%, similar to that reported in women. Forearm fractures should probably not be regarded as a public health problem. Peak bone mass is higher in men than women because men have bigger bones. Peak bone mineral density is the same. The amount of trabecular bone lost at the spine and iliac crest during ageing is similar in men and women. Cortical bone loss is less in men because endocortical resorption is less and periosteal formation is greater. Bone loss accelerates in elderly men because endocortical resorption and increasing cortical porosity increase the surface available for resorption. Bone fragility is less in men than women because: (a) the cross-sectional surface of the bone is larger; (b) trabecular bone loss is less as a percentage of the higher peak bone mass; (c) trabecular bone loss occurs by thinning rather than perforation; and (d) periosteal appositional growth compensates for endocortical resorption by maintaining the bending strength of bone. Reduced BMD in men with fractures may be due to reduced peak bone size and mass, and bone loss. Bone loss occurs by reduced bone formation. Whether men with fractures have increased bone fragility due to reduced periosteal appositional growth during ageing is unknown. The age-related decline in testosterone, adrenal androgens, growth hormone, and insulin-like growth factor 1 may contribute to reduced bone formation and bone loss. Men with vertebral fractures often have hypogonadism or illnesses with few clinical features that should be considered with a high index of suspicion (alcoholism, myeloma, malabsorption, primary hyperparathyroidism, haemochromatosis, Cushing's disease). Secondary hyperparathyroidism may contribute to bone loss by activating bone turnover and so increasing the number of bone remodelling units with impaired bone formation in each. There is no proven treatment for osteoporosis in men because there have been no trials using anti-fracture efficacy as an end point. Testosterone replacement should be considered in men with proven hypogonadism and vitamin D deficiency should be corrected if present. Calcium supplements and bisphosphonates are reasonable options given the lack of information.

Hip fracture incidence among Caucasians in Hawaii is similar to Japanese. A population-based study.

Age-specific hip fracture incidence has been increasing in some parts of the world. The incidence of hip fractures among Japanese on the island of Oahu, Hawaii in 1979-1981 was approximately half that of Caucasians in North America, but similar to the incidence in Japan. We surveyed the incidence on Oahu again in 1991-1995 for all races to compare the incidence among Japanese to the earlier rates, and to other populations, including Caucasians on Oahu. The incidence of hip fracture among Japanese in Hawaii between 1991-1995 had not changed appreciably (compared to 1979-1981), and was similar to that among Caucasians on Oahu. The incidence among Hawaii Japanese and Caucasians was similar to, or lower than Japan overall, and much lower (one-third to one-half) than that reported for Caucasians in North America and Northern Europe, suggesting that the prevalence of certain risk factors may be lower in Hawaii. These findings confirm other studies suggesting that nongenetic factors may be responsible for much of the observed differences in hip fracture incidence between countries, and between races.

Osteoporosis: gender differences and similarities.

Although osteoporosis has traditionally been considered a disease of women, men also incur substantial bone loss with aging, and elderly men have age-specific hip fracture incidence rates and vertebral fracture prevalence rates that are at least half those in women. Early postmenopausal bone loss (which results in the syndrome of type I osteoporosis) is due to the direct skeletal consequences of estrogen deficiency, manifested by an increase in bone resorption without an adequate increase in bone formation. Recent evidence indicates that even late postmenopausal bone loss (type II or 'smile' osteoporosis) in women may be due to estrogen deficiency. In particular, the late consequences of estrogen deficiency in elderly women result in abnormalities in calcium homeostasis and increases in parathyroid hormone secretion, leading to increased bone resorption and bone loss. The etiology of bone loss in aging men has remained relatively unclear. Recent evidence from a male deficient in estrogen receptor-alpha and in two males with aromatase deficiency indicate that estrogen may play a significant role in bone metabolism in men. Moreover, several large epidemiologic studies have found that bone mineral density correlates better with serum estrogen than testosterone in aging men. Thus estrogen deficiency may lead to bone loss in men.

Osteoporosis in men.

Hip fractures in men account for one third of all hip fractures and have a higher mortality than in women. The public health burden will increase as the increase in the numbers of elderly men in the community increases. In addition, the age-specific incidence of hip fractures may be increasing in some, but not all, countries. Vertebral fractures may be a public health problem as recent studies suggest that the prevalence in the community is 20-30%, similar to that reported in women. Forearm fractures should probably not be regarded as a public health problem. Peak bone mass is higher in men than women because men have bigger bones. Peak bone mineral density is the same. The amount of trabecular bone lost at the spine and iliac crest during ageing is similar in men and women. Cortical bone loss is less in men because endocortical resorption is less and periosteal formation is greater. Bone loss accelerates in elderly men because endocortical resorption and increasing cortical porosity increase the surface available for resorption. Bone fragility is less in men than women because: (a) the cross-sectional surface of the bone is larger; (b) trabecular bone loss is less as a percentage of the higher peak bone mass; (c) trabecular bone loss occurs by thinning rather than perforation; and (d) periosteal appositional growth compensates for endocortical resorption by maintaining the bending strength of bone. Reduced BMD in men with fractures may be due to reduced peak bone size and mass, and bone loss. Bone loss occurs by reduced bone formation. Whether men with fractures have increased bone fragility due to reduced periosteal appositional growth during ageing is unknown. The age-related decline in testosterone, adrenal androgens, growth hormone, and insulin-like growth factor 1 may contribute to reduced bone formation and bone loss. Men with vertebral fractures often have hypogonadism or illnesses with few clinical features that should be considered with a high index of suspicion (alcoholism, myeloma, malabsorption, primary hyperparathyroidism, haemochromatosis, Cushing's disease). Secondary hyperparathyroidism may contribute to bone loss by activating bone turnover and so increasing the number of bone remodelling units with impaired bone formation in each. There is no proven treatment for osteoporosis in men because there have been no trials using anti-fracture efficacy as an end point. Testosterone replacement should be considered in men with proven hypogonadism and vitamin D deficiency should be corrected if present. Calcium supplements and bisphosphonates are reasonable options given the lack of information.

9 Osteoporosis in men

Hip fractures in men account for one third of all hip fractures and have a higher mortality than in women. The public health burden will increase as the increase in the numbers of elderly men in the community increases. In addition, the age-specific incidence of hip fractures may be increasing in some, but not all, countries. Vertebral fractures may be a public health problem as recent studies suggest that the prevalence in the community is 20-30%, similar to that reported in women. Forearm fractures should probably not be regarded as a public health problem. Peak bone mass is higher in men than women because men have bigger bones. Peak bone mineral density is the same. The amount of trabecular bone lost at the spine and iliac crest during ageing is similar in men and women. Cortical bone loss is less in men because endocortical resorption is less and periosteal formation is greater. Bone loss accelerates in elderly men because endocortical resorption and increasing cortical porosity increase the surface available for resorption. Bone fragility is less in men than women because: (a) the cross-sectional surface of the bone is larger; (b) trabecular bone loss is less as a percentage of the higher peak bone mass; (c) trabecular bone loss occurs by thinning rather than perforation; and (d) periosteal appositional growth compensates for endocortical resorption by maintaining the bending strength of bone. Reduced BMD in men with fractures may be due to reduced peak bone size and mass, and bone loss. Bone loss occurs by reduced bone formation. Whether men with fractures have increased bone fragility due to reduced periosteal appositional growth during ageing is unknown. The age-related decline in testosterone, adrenal androgens, growth hormone, and insulin-like growth factor 1 may contribute to reduced bone formation and bone loss. Men with vertebral fractures often have hypogonadism or illnesses with few clinical features that should be considered with a high index of suspicion (alcoholism, myeloma, malabsorption, primary hyperparathyroidism, haemochromatosis, Cushing's disease). Secondary hyperparathyroidism may contribute to bone loss by activating bone turnover and so increasing the number of bone remodelling units with impaired bone formation in each. There is no proven treatment for osteoporosis in men because there have been no trials using anti-fracture efficacy as an end point. Testosterone replacement should be considered in men with proven hypogonadism and vitamin D deficiency should be corrected if present. Calcium supplements and bisphosphonates are reasonable options given the lack of information.

The dilemma of osteoporosis in men

Hip fractures in men account for one third of all hip fractures and have a higher mortality than in women. The age-specific incidence of hip fractures is increasing so that the public health burden will increase out of proportion to the burden imposed by the increase in the numbers of elderly men in the community. Vertebral fractures are a public health problem of lesser magnitude in terms of morbidity, mortality, and cost, but they are debilitating and are seen commonly in clinical practice. (Forearm fractures should probably not be regarded as a public health problem.) The pattern of earlier gain/later loss of bone during ageing in healthy men is well documented. Peak bone mass is higher in men than women because men have bigger bones. Peak bone density is the same. The absolute amount of trabecular bone lost at the spine and iliac crest during ageing is similar in men and women. Cortical bone loss is less in men. It is less because endocortical resorption is less, and periosteal formation is greater, in men. Bone loss may accelerate in elderly men and women (rather than decelerate), perhaps because endocortical resorption and increasing cortical porosity increase the effective surface available for resorption in cortical bone. Thus, bone fragility is less in men because (a) the cross-sectional surface of the vertebral body is larger; (b) trabecular bone loss is less as a percentage of the higher peak bone mass; (c) trabecular bone loss occurs by thinning rather than perforation; and (d) periosteal appositional growth compensates for endocortical resorption by maintaining the bending strength of bone. Reduced bone density in men with fractures may be due to reduced peak bone density and bone loss. As found in women with spine fractures, men with fractures have smaller bone size. Bone loss occurs by reduced bone formation and increased bone resorption. Loss of connectivity appears to predominate in men with vertebral fractures; trabecular thinning appears to predominate in men with hip fractures. Whether men with fractures have increased bone fragility due to reduced periosteal appositional growth during ageing is unknown. The age-related decline in testosterone, adrenal androgens, growth hormone, and insulinlike growth factor 1 may be concomitants of ageing or may contribute to reduced bone formation and bone loss. Men with vertebral fractures may be more deficient in growth hormone and insulin-like growth factor 1. They often have illness, hypogonadism, or illnesses associated with hypogonadism that should be sought with a high index of suspicion. Secondary hyperparathyroidism may contribute to bone loss by activating bone turnover and so increasing the number of bone remodeling units with impaired bone formation. There is no known treatment for osteoporosis in men because there have been no trials using antifracture efficacy as an endpoint and few using other endpoints. Decisions are based on studies in women; on endpoints such as bone densitometry, markers of bone turnover, and histomorphometry; and on studies in animal models of osteoporosis.