title: Hospitalization for fractures and bone loss in adults. Why do we regard these phenomena as dull?
abstract: The epidemiology of serious fractures in adults relates less to the frequency of forceful accidents and more directly to the loss of bone in middle-aged and older people. To support this statement, hospital discharge rates for fractures in recent years are examined from different geographic areas. Rates for the United States rise with age, so that serious fractures form 10 percent of all hospital discharges at 85 years and older. Saskatchewan data suggest that rates for men remain low until 60 years; for women the figures began to rise at 45 years, before many had reached the menopause. Rates are lower among women than men in Saskatchewan until around 50 years, surpassing those of men at age 55 and older. Among Medicare enrollees in 1967 in the United States, women had higher discharge rates for fractures than men of the same age and race. Whites also had higher rates than blacks, so much so that white males had higher rates than black women of the same age. Such data confirm the past impression that blacks who survive into the older ages are a biological elite, more able to maintain bone strength than whites of either sex, although by no means being exempt from bone loss with age. A fractured femur was the most frequent diagnosis, forming a higher percentage of all fractures in women than men, and rising steeply with age in both sexes. The pattern of fractures by sex differs from the epidemiology of forceful accidents, which more often involve men than women. Bone loss with age, or osteoporosis, is perhaps the most powerful host factor to dominate the picture of fractures in the elderly. The existing possibilities for preventing or slowing this change are thus assessed; women may no longer accept as natural the widespread bone loss and accompanying fractures that lower the quality of life in later years.
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000375:Aging; D044383:Black People; D001862:Bone Resorption; D001842:Bone and Bones / Q000502:physiology*; D004032:Diet; D004739:England; D004967:Estrogens / Q000502:physiology; D005260:Female; D005264:Femoral Fractures; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology; D006760:Hospitalization; D006801:Humans; D008297:Male; D006278:Medicare; D008875:Middle Aged; D010024:Osteoporosis / Q000503:physiopathology; D005082:Physical Exertion; D012525:Saskatchewan; D012737:Sex Factors; D014481:United States; D014852:Wales
chemical_list: D004967:Estrogens