Prevalence of osteoporosis and incidence of hip fracture in women--secular trends over 30 years.
BACKGROUND
The number of hip fractures during recent decades has been reported to be increasing, partly because of an increasing proportion of elderly women in the society. However, whether changes in hip fracture annual incidence in women are attributable to secular changes in the prevalence of osteoporosis is unclear.


METHODS
Bone mineral density was evaluated by single-photon absorptiometry at the distal radius in 456 women aged 50 years or above and living in the same city. The measurements were obtained by the same densitometer during three separate time periods: 1970-74 (n = 106), 1987-93 (n = 175) and 1998-1999 (n = 178), and the age-adjusted prevalence of osteoporosis in these three cohorts was calculated. Additionally, all hip fractures sustained in the target population of women aged 50 years or above between 1967 and 2001 were registered, whereupon the crude and the age-adjusted annual incidence of hip fractures were calculated.


RESULTS
There was no significant difference in the age-adjusted prevalence of osteoporosis when the three cohorts were compared (P = 1.00). The crude annual incidence (per 10,000 women) of hip fracture in the target population increased by 110% from 40 in 1967 to 84 in 2001. The overall trend in the crude incidence between 1967 and 2001 was increasing (1.58 per 10,000 women per year; 95 percent confidence interval, 1.17 to 1.99), whereas the age-adjusted incidence was stable over the same period (0.22 per 10,000 women per year; 95 percent confidence interval, -0.16 to 0.60).


CONCLUSIONS
The increased number of hip fracture in elderly women is more likely to be attributable to demographic changes in the population than to secular increase in the prevalence of osteoporosis.
Ahlborg
Henrik G
HG
Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Science, Lund University, Malmö University Hospital, SE-20502 Malmö, Sweden. Henrik.Ahlborg@med.lu.se
Rosengren
Björn E
BE
Järvinen
Teppo L N
TL
Rogmark
Cecilia
C
Nilsson
Jan-Ake
JA
Sernbo
Ingemar
I
Karlsson
Magnus K
MK
D015502:Absorptiometry, Photon; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D015519:Bone Density / Q000502:physiology; D015331:Cohort Studies; D015897:Comorbidity; D003710:Demography; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology* / Q000503:physiopathology; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D011884:Radius / Q000000981:diagnostic imaging / Q000502:physiology; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors