Skip to main content
Top
Published in: Osteoporosis International 4/2019

01-04-2019 | Original Article

Hip fractures in Singapore: ethnic differences and temporal trends in the new millennium

Authors: E. L. Yong, G. Ganesan, M.S. Kramer, S. Logan, T.C. Lau, J.A. Cauley, K.B. Tan

Published in: Osteoporosis International | Issue 4/2019

Login to get access

Abstract

Summary

Despite an increase in absolute numbers, the age-standardized incidence of hip fractures in Singapore declined in the period 2000 to 2017. Among the three major ethnic groups, Chinese women had the highest fracture rates but were the only group to show a temporal decline.

Introduction

A study published in 2001 predicted a 30–50% increase in Singapore hip fracture incidence rates over the ensuing 30 years. To test that prediction, we examined the incidence of hip fracture in Singapore from 2000 to 2017.

Methods

We carried out a population-based study of hip fractures among Singapore residents aged ≥ 50 years. National medical insurance claims data were used to identify admissions with a primary discharge diagnosis of hip fracture. Age-adjusted rates, based on the age distribution of the Singapore population of 2000, were analyzed separately by sex and ethnicity (Chinese, Malay, or Indian).

Results

Over the 18-year study period, 36,082 first hip fractures were recorded. Total hip fracture admissions increased from 1487 to 2729 fractures/year in the years 2000 to 2017. Despite this absolute increase, age-adjusted fracture rates declined, with an average annual change of − 4.3 (95% CI − 5.0, − 3.5) and − 1.1 (95% CI − 1.7, − 0.5) fractures/100,000/year for women and men respectively. Chinese women had 1.4- and 1.9-fold higher age-adjusted rates than Malay and Indian women: 264 (95% CI 260, 267) versus 185 (95% CI 176, 193) and 141 (95% CI 132, 150) fractures/100,000/year, respectively. Despite their higher fracture rates, Chinese women were the only ethnic group exhibiting a decline, most evident in those ≥ 85 years, in age-adjusted fracture rate of − 5.3 (95% CI − 6.0, − 4.5) fractures/100,000/year.

Conclusion

Although the absolute number of fractures increased, steep drops in elderly Chinese women drove a reduction in overall age-adjusted hip fracture rates. Increases in the older population will lead to a rise in total number of hip fractures, requiring budgetary planning and new preventive strategies.
Appendix
Available only for authorised users
Literature
16.
go back to reference Chandran M, Tay D, Huang XF, Hao Y (2018) The burden of inpatient care for diabetic and non-diabetic patients with osteoporotic hip fractures-does it differ? An analysis of patients recruited into a fracture liaison service in Southeast Asia. Arch Osteoporos 15(13):27. https://doi.org/10.1007/s11657-018-0440-x CrossRef Chandran M, Tay D, Huang XF, Hao Y (2018) The burden of inpatient care for diabetic and non-diabetic patients with osteoporotic hip fractures-does it differ? An analysis of patients recruited into a fracture liaison service in Southeast Asia. Arch Osteoporos 15(13):27. https://​doi.​org/​10.​1007/​s11657-018-0440-x CrossRef
17.
go back to reference Fujiwara S, Zhao X, Teoh C, Jaffe DH, Taguchi Y (2018) Disease burden of fractures among patients with osteoporosis in Japan: health-related quality of life, work productivity and activity impairment, healthcare resource utilization, and economic costs. J Bone Miner Metab. https://doi.org/10.1007/s00774-018-0916-1 Fujiwara S, Zhao X, Teoh C, Jaffe DH, Taguchi Y (2018) Disease burden of fractures among patients with osteoporosis in Japan: health-related quality of life, work productivity and activity impairment, healthcare resource utilization, and economic costs. J Bone Miner Metab. https://​doi.​org/​10.​1007/​s00774-018-0916-1
19.
go back to reference National Health Survey (2010) Epidemiology and Disease Control Division. Ministry of Health, Singapore National Health Survey (2010) Epidemiology and Disease Control Division. Ministry of Health, Singapore
30.
go back to reference Leong KH (2002) Medical treatment of osteoporosis--increasing options. Ann Acad Med Singap 31:43–47PubMed Leong KH (2002) Medical treatment of osteoporosis--increasing options. Ann Acad Med Singap 31:43–47PubMed
31.
go back to reference Leong KH, Koh LK, Ng DC (2002) Osteoporosis: a treatable disease. Ann Acad Med Singap 31:1–2PubMed Leong KH, Koh LK, Ng DC (2002) Osteoporosis: a treatable disease. Ann Acad Med Singap 31:1–2PubMed
32.
go back to reference Straits Times (1996) Women “unaware that osteoporosis can be treated” September 26 Straits Times (1996) Women “unaware that osteoporosis can be treated” September 26
Metadata
Title
Hip fractures in Singapore: ethnic differences and temporal trends in the new millennium
Authors
E. L. Yong
G. Ganesan
M.S. Kramer
S. Logan
T.C. Lau
J.A. Cauley
K.B. Tan
Publication date
01-04-2019
Publisher
Springer London
Published in
Osteoporosis International / Issue 4/2019
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-019-04839-5

Other articles of this Issue 4/2019

Osteoporosis International 4/2019 Go to the issue