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Published in: Osteoporosis International 12/2008

01-12-2008 | Original Article

Reversal of the hip fracture secular trend is related to a decrease in the incidence in institution-dwelling elderly women

Authors: E. Guilley, T. Chevalley, F. Herrmann, D. Baccino, P. Hoffmeyer, C.-H. Rapin, R. Rizzoli

Published in: Osteoporosis International | Issue 12/2008

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Abstract

Summary

In this prospective 10-year study in elderly aged 60 years and over, there was a 1.3% per year reduction in the standardized incidence of hip fracture in women but not in men. This decrease was mainly due to changes in the standardized incidence of hip fracture in institution-dwelling women.

Introduction

A decrease in age-adjusted hip fracture incidence has been recently demonstrated in some countries. Since a large proportion of hip fractures occur in nursing homes, we analyzed whether this decreasing trend would be more detectable in institution-dwelling elderly compared with community-dwelling elderly.

Methods

All hip fracture patients aged 60 years and over were identified in a well-defined area. Incidence of hip fracture, age- and sex-adjusted to the 2000 Geneva population, was computed in community- and institution-dwelling elderly.

Results

From 1991 to 2000, 1,624 (41%) hip fractures were recorded in institutionalized-dwelling elderly and 2,327 (59%) in community-dwelling elderly. The standardized fracture incidence decreased by 1.3% per year in women (p = 0.039), but remained unchanged in men (+0.5%; p = 0.686). Among institution-dwelling women, hip fracture incidence fell by 1.9% per year (p = 0.044), whereas it remained stable among community-dwelling women (+0.0%, p = 0.978). In men, no significant change in hip fracture incidence occurred among institution- or community-dwelling elderly.

Conclusions

The decrease in the standardized hip fracture incidence in institution-dwelling women is responsible for the reversal in secular trend. Future research should include stratification according to the residential status to better identify the causes responsible for the trend in hip fracture incidence.
Literature
1.
2.
go back to reference Johnell O, Kanis J (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733PubMedCrossRef Johnell O, Kanis J (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733PubMedCrossRef
3.
go back to reference Brennan J, Johansen A, Butler J et al (2003) Place of residence and risk of fracture in older people: a population-based study of over 65-year-olds in Cardiff. Osteoporos Int 14:515–519CrossRef Brennan J, Johansen A, Butler J et al (2003) Place of residence and risk of fracture in older people: a population-based study of over 65-year-olds in Cardiff. Osteoporos Int 14:515–519CrossRef
4.
go back to reference Butler M, Norton R, Lee-Joe T et al (1996) The risks of hip fracture in older people from private homes and institutions. Age Ageing 25:381–385PubMedCrossRef Butler M, Norton R, Lee-Joe T et al (1996) The risks of hip fracture in older people from private homes and institutions. Age Ageing 25:381–385PubMedCrossRef
5.
go back to reference Cumming RG (1996) Nursing home residence and risk of hip fracture. Am J Epidemiol 144:1191–1194 Cumming RG (1996) Nursing home residence and risk of hip fracture. Am J Epidemiol 144:1191–1194
6.
go back to reference Norton R, Campbell AJ, Reid IR et al (1999) Residential status and risk of hip fracture. Age Ageing 28:135–139PubMedCrossRef Norton R, Campbell AJ, Reid IR et al (1999) Residential status and risk of hip fracture. Age Ageing 28:135–139PubMedCrossRef
7.
go back to reference Ooms ME, Vlasman P, Lips P et al (1994) The incidence of hip fractures in independent and institutionalised elderly people. Osteoporos Int 4:6–10PubMedCrossRef Ooms ME, Vlasman P, Lips P et al (1994) The incidence of hip fractures in independent and institutionalised elderly people. Osteoporos Int 4:6–10PubMedCrossRef
8.
go back to reference Balasegaram S, Majeed A, Fitz-Clarence H (2001) Trends in hospital admissions for fractures of the hip and femur in England, 1989–1990 to 1997–1998. J Public Health Med 23:11–17PubMedCrossRef Balasegaram S, Majeed A, Fitz-Clarence H (2001) Trends in hospital admissions for fractures of the hip and femur in England, 1989–1990 to 1997–1998. J Public Health Med 23:11–17PubMedCrossRef
9.
go back to reference Boufous S, Finch CF, Lord SR (2004) Incidence of hip fracture in New South Wales: are our efforts having an effect? Med J Aust 180:623–626PubMed Boufous S, Finch CF, Lord SR (2004) Incidence of hip fracture in New South Wales: are our efforts having an effect? Med J Aust 180:623–626PubMed
10.
go back to reference Hernandez JL, Olmos JM, Alonso MA et al (2006) Trend in hip fracture epidemiology over a 14-year period in a Spanish population. Osteoporos Int 17:464–470PubMedCrossRef Hernandez JL, Olmos JM, Alonso MA et al (2006) Trend in hip fracture epidemiology over a 14-year period in a Spanish population. Osteoporos Int 17:464–470PubMedCrossRef
11.
go back to reference Huusko TM, Karppi P, Avikainen V et al (1999) The changing picture of hip fractures: dramatic change in age distribution and no change in age-adjusted incidence within 10 years in Central Finland. Bone 24:257–259PubMedCrossRef Huusko TM, Karppi P, Avikainen V et al (1999) The changing picture of hip fractures: dramatic change in age distribution and no change in age-adjusted incidence within 10 years in Central Finland. Bone 24:257–259PubMedCrossRef
12.
go back to reference Lau EM, Cooper C, Fung H et al (1999) Hip fracture in Hong Kong over the last decade—a comparison with the UK. J Public Health Med 21:249–250PubMedCrossRef Lau EM, Cooper C, Fung H et al (1999) Hip fracture in Hong Kong over the last decade—a comparison with the UK. J Public Health Med 21:249–250PubMedCrossRef
13.
go back to reference Chang KP, Center JR, Nguyen TV et al (2004) Incidence of hip and other osteoporotic fractures in elderly men and women: Dubbo osteoporosis epidemiology study. J Bone Miner Res 19:532–536PubMedCrossRef Chang KP, Center JR, Nguyen TV et al (2004) Incidence of hip and other osteoporotic fractures in elderly men and women: Dubbo osteoporosis epidemiology study. J Bone Miner Res 19:532–536PubMedCrossRef
14.
go back to reference Jaglal S, Weller I, Mamdani M et al (2005) Population trends in BMD testing, treatment, and hip and wrist fracture rates: are the hip fracture projections wrong? J Bone Miner Res 20:898–905PubMedCrossRef Jaglal S, Weller I, Mamdani M et al (2005) Population trends in BMD testing, treatment, and hip and wrist fracture rates: are the hip fracture projections wrong? J Bone Miner Res 20:898–905PubMedCrossRef
15.
go back to reference Kannus P, Niemi S, Parkkari J et al (2006) Nationwide decline in incidence of hip fracture. J Bone Miner Metab 21:1836–1838 Kannus P, Niemi S, Parkkari J et al (2006) Nationwide decline in incidence of hip fracture. J Bone Miner Metab 21:1836–1838
16.
go back to reference Melton LJ, Atkinson EJ, Madhok R (1996) Downturn in hip fracture incidence. Public Health Rep 111:146–151PubMed Melton LJ, Atkinson EJ, Madhok R (1996) Downturn in hip fracture incidence. Public Health Rep 111:146–151PubMed
17.
go back to reference Chevalley T, Herrmann F, Delmi M et al (2002) Evaluation of the age-adjusted incidence of hip fractures between urban and rural areas: the difference is not related to the prevalence of institutions for the elderly. Osteoporos Int 13:113–118PubMedCrossRef Chevalley T, Herrmann F, Delmi M et al (2002) Evaluation of the age-adjusted incidence of hip fractures between urban and rural areas: the difference is not related to the prevalence of institutions for the elderly. Osteoporos Int 13:113–118PubMedCrossRef
18.
go back to reference Chevalley T, Guilley E, Herrmann F et al (2007) Incidence of hip fracture over a 10-year period (1991–2000): reversal of a secular trend. Bone 40:1284–1289PubMedCrossRef Chevalley T, Guilley E, Herrmann F et al (2007) Incidence of hip fracture over a 10-year period (1991–2000): reversal of a secular trend. Bone 40:1284–1289PubMedCrossRef
19.
go back to reference Chapuy MC, Arlot ME, Duboeuf F et al (1992) Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 327:1637–1642PubMed Chapuy MC, Arlot ME, Duboeuf F et al (1992) Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 327:1637–1642PubMed
20.
go back to reference Chevalley T, Rizzoli R, Nydegger V et al (1994) Effects of calcium supplements on femoral bone mineral density and vertebral fracture rate in vitamin-D-replete elderly patients. Osteoporos Int 4:245–252PubMedCrossRef Chevalley T, Rizzoli R, Nydegger V et al (1994) Effects of calcium supplements on femoral bone mineral density and vertebral fracture rate in vitamin-D-replete elderly patients. Osteoporos Int 4:245–252PubMedCrossRef
21.
go back to reference Feder G, Cryer C, Donovan S et al (2000) Guidelines for the prevention of falls in people over 65. The guidelines’ development group. BMJ 321:1007–1011PubMedCrossRef Feder G, Cryer C, Donovan S et al (2000) Guidelines for the prevention of falls in people over 65. The guidelines’ development group. BMJ 321:1007–1011PubMedCrossRef
22.
go back to reference Schaad M-A, Bonjour JP, Rizzoli R (2000) Evaluation of hormone replacement therapy use by the sales figures. Maturitas 34:185–191PubMedCrossRef Schaad M-A, Bonjour JP, Rizzoli R (2000) Evaluation of hormone replacement therapy use by the sales figures. Maturitas 34:185–191PubMedCrossRef
23.
go back to reference Schürch MA, Rizzoli R, Slosman D et al (1998) Protein supplements increase serum insulin-like growth factor-I levels and attenuate proximal femur bone loss in patients with recent hip fracture. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 128:801–809PubMed Schürch MA, Rizzoli R, Slosman D et al (1998) Protein supplements increase serum insulin-like growth factor-I levels and attenuate proximal femur bone loss in patients with recent hip fracture. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 128:801–809PubMed
24.
go back to reference Wysowski DK, Golden L, Burke L (1995) Use of menopausal estrogens and medroxyprogesterone in the United States, 1982–1992. Obstet Gynecol 85:6–10PubMedCrossRef Wysowski DK, Golden L, Burke L (1995) Use of menopausal estrogens and medroxyprogesterone in the United States, 1982–1992. Obstet Gynecol 85:6–10PubMedCrossRef
25.
go back to reference Wanner P, Sauvain-Dugerdil C, Guilley E et al (2005) Ages et générations: la vie après 50 ans en Suisse; analyse générale du recensement de la population 2000. OFS, Neuchâtel Wanner P, Sauvain-Dugerdil C, Guilley E et al (2005) Ages et générations: la vie après 50 ans en Suisse; analyse générale du recensement de la population 2000. OFS, Neuchâtel
26.
go back to reference Schürch MA, Rizzoli R, Mermillod B et al (1996) A prospective study on socioeconomic aspects of fracture of the proximal femur. J Bone Miner Res 11:1935–1942PubMedCrossRef Schürch MA, Rizzoli R, Mermillod B et al (1996) A prospective study on socioeconomic aspects of fracture of the proximal femur. J Bone Miner Res 11:1935–1942PubMedCrossRef
27.
go back to reference Lewinnek G, Kelsey J, White A et al (1980) The significance and a comparative analysis of the epidemiology of hip fractures. Clin Orthop Relat Res 152:35–43PubMed Lewinnek G, Kelsey J, White A et al (1980) The significance and a comparative analysis of the epidemiology of hip fractures. Clin Orthop Relat Res 152:35–43PubMed
28.
go back to reference Hagino H, Katagiri H, Okano T et al (2005) Increasing incidence of hip fracture in Tottori Prefecture, Japan: trend from 1986 to 2001. Osteoporos Int 16:1963–1968PubMedCrossRef Hagino H, Katagiri H, Okano T et al (2005) Increasing incidence of hip fracture in Tottori Prefecture, Japan: trend from 1986 to 2001. Osteoporos Int 16:1963–1968PubMedCrossRef
29.
go back to reference Iga T, Dohmae Y, Endo N et al (1999) Increase in the incidence of cervical and trochanteric fractures of the proximal femur in Niigata Prefecture, Japan. J Bone Miner Metab 17:224–231PubMedCrossRef Iga T, Dohmae Y, Endo N et al (1999) Increase in the incidence of cervical and trochanteric fractures of the proximal femur in Niigata Prefecture, Japan. J Bone Miner Metab 17:224–231PubMedCrossRef
30.
go back to reference Kannus P, Niemi S, Parkkari J et al (1999) Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 353:802–805PubMedCrossRef Kannus P, Niemi S, Parkkari J et al (1999) Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 353:802–805PubMedCrossRef
31.
go back to reference Lönnroos E, Kautiainen H, Karppi P et al (2006) Increased incidence of hip fracture. A population based-study in Finland. Bone 39:623–627PubMedCrossRef Lönnroos E, Kautiainen H, Karppi P et al (2006) Increased incidence of hip fracture. A population based-study in Finland. Bone 39:623–627PubMedCrossRef
32.
go back to reference Avenell A, Gillespie WJ, Gillespie LD et al (2005) Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Database Syst Rev 20:CD000227 Avenell A, Gillespie WJ, Gillespie LD et al (2005) Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Database Syst Rev 20:CD000227
33.
go back to reference Lilliu H, Pamphile R, Chapuy MC et al (2003) Calcium-vitamin D3 supplementation is cost-effective in hip fractures prevention. Maturitas 44:299–305PubMedCrossRef Lilliu H, Pamphile R, Chapuy MC et al (2003) Calcium-vitamin D3 supplementation is cost-effective in hip fractures prevention. Maturitas 44:299–305PubMedCrossRef
34.
go back to reference Kiel DP, Magaziner J, Zimmerman S et al (2007) Efficacy of a hip protector to prevent hip fracture in nursing home residents: the HIP PRO randomized controlled trial. JAMA 298:413–422PubMedCrossRef Kiel DP, Magaziner J, Zimmerman S et al (2007) Efficacy of a hip protector to prevent hip fracture in nursing home residents: the HIP PRO randomized controlled trial. JAMA 298:413–422PubMedCrossRef
35.
go back to reference Parker MJ, Gillespie WJ, Gillespie LD (2006) Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review. BMJ 332:571–574PubMedCrossRef Parker MJ, Gillespie WJ, Gillespie LD (2006) Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review. BMJ 332:571–574PubMedCrossRef
36.
go back to reference Hauselmann HJ, Rizzoli R (2003) A comprehensive review of treatments for postmenopausal osteoporosis. Osteoporos Int 14:2–12PubMedCrossRef Hauselmann HJ, Rizzoli R (2003) A comprehensive review of treatments for postmenopausal osteoporosis. Osteoporos Int 14:2–12PubMedCrossRef
37.
go back to reference Black DM, Cummings SR, Karpf DB et al (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet 348:1535–1541PubMedCrossRef Black DM, Cummings SR, Karpf DB et al (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet 348:1535–1541PubMedCrossRef
38.
go back to reference McClung MR, Geusens P, Miller PD et al (2001) Effect of risedronate on the risk of hip fracture in elderly women. Hip intervention program study group. N Engl J Med 344:333–340PubMedCrossRef McClung MR, Geusens P, Miller PD et al (2001) Effect of risedronate on the risk of hip fracture in elderly women. Hip intervention program study group. N Engl J Med 344:333–340PubMedCrossRef
39.
go back to reference Chevalley T, Hoffmeyer P, Bonjour JP et al (2002) An osteoporosis clinical pathway for the medical management of patients with low-trauma fracture. Osteoporos Int 13:450–455PubMedCrossRef Chevalley T, Hoffmeyer P, Bonjour JP et al (2002) An osteoporosis clinical pathway for the medical management of patients with low-trauma fracture. Osteoporos Int 13:450–455PubMedCrossRef
40.
go back to reference Feldstein A, Elmer PJ, Orwoll E et al (2003) Bone mineral density measurement and treatment for osteoporosis in older individuals with fractures: a gap in evidence-based practice guideline implementation. Arch Intern Med 163:2165–2172PubMedCrossRef Feldstein A, Elmer PJ, Orwoll E et al (2003) Bone mineral density measurement and treatment for osteoporosis in older individuals with fractures: a gap in evidence-based practice guideline implementation. Arch Intern Med 163:2165–2172PubMedCrossRef
41.
go back to reference Jachna CM, Shireman TI, Whittle J et al (2005) Differing patterns of antiresorptive pharmacotherapy in nursing facility residents and community dwellers. J Am Geriatr Soc 53:1275–1281PubMedCrossRef Jachna CM, Shireman TI, Whittle J et al (2005) Differing patterns of antiresorptive pharmacotherapy in nursing facility residents and community dwellers. J Am Geriatr Soc 53:1275–1281PubMedCrossRef
42.
go back to reference Feldstein AC, Nichols G, Orwoll E et al (2005) The near absence of osteoporosis treatment in older men with fractures. Osteoporos Int 16:953–962PubMedCrossRef Feldstein AC, Nichols G, Orwoll E et al (2005) The near absence of osteoporosis treatment in older men with fractures. Osteoporos Int 16:953–962PubMedCrossRef
43.
go back to reference Van Staa TP, Dennison EM, Leufkens HG et al (2001) Epidemiology of fractures in England and Wales. Bone 29:517–522PubMedCrossRef Van Staa TP, Dennison EM, Leufkens HG et al (2001) Epidemiology of fractures in England and Wales. Bone 29:517–522PubMedCrossRef
44.
45.
go back to reference Löfman O, Berglund K, Larsson L et al (2002) Changes in hip fracture epidemiology: redistribution between ages, genders and fracture types. Osteoporos Int 13:18–25PubMedCrossRef Löfman O, Berglund K, Larsson L et al (2002) Changes in hip fracture epidemiology: redistribution between ages, genders and fracture types. Osteoporos Int 13:18–25PubMedCrossRef
46.
go back to reference Trombetti A, Herrmann F, Hoffmeyer P et al (2002) Survival and potential years of life lost after hip fracture in men and age-matched women. Osteoporos Int 13:731–737PubMedCrossRef Trombetti A, Herrmann F, Hoffmeyer P et al (2002) Survival and potential years of life lost after hip fracture in men and age-matched women. Osteoporos Int 13:731–737PubMedCrossRef
Metadata
Title
Reversal of the hip fracture secular trend is related to a decrease in the incidence in institution-dwelling elderly women
Authors
E. Guilley
T. Chevalley
F. Herrmann
D. Baccino
P. Hoffmeyer
C.-H. Rapin
R. Rizzoli
Publication date
01-12-2008
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 12/2008
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-008-0610-6

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