Hip fracture epidemiological trends, outcomes, and risk factors, 1970-2009.
Hip fractures - which commonly lead to premature death, high rates of morbidity, or reduced life quality - have been the target of a voluminous amount of research for many years. But has the lifetime risk of incurring a hip fracture decreased sufficiently over the last decade or are high numbers of incident cases continuing to prevail, despite a large body of knowledge and a variety of contemporary preventive and refined surgical approaches? This review examines the extensive hip fracture literature published in the English language between 1980 and 2009 concerning hip fracture prevalence trends, and injury mechanisms. It also highlights the contemporary data concerning the personal and economic impact of the injury, plus potentially remediable risk factors underpinning the injury and ensuing disability. The goal was to examine if there is a continuing need to elucidate upon intervention points that might minimize the risk of incurring a hip fracture and its attendant consequences. Based on this information, it appears hip fractures remain a serious global health issue, despite some declines in the incidence rate of hip fractures among some women. Research also shows widespread regional, ethnic and diagnostic variations in hip fracture incidence trends. Key determinants of hip fractures include age, osteoporosis, and falls, but some determinants such as socioeconomic status, have not been well explored. It is concluded that while more research is needed, well-designed primary, secondary, and tertiary preventive efforts applied in both affluent as well as developing countries are desirable to reduce the present and future burden associated with hip fracture injuries. In this context, and in recognition of the considerable variation in manifestation and distribution, as well as risk factors underpinning hip fractures, well-crafted comprehensive, rather than single solutions, are strongly indicated in early rather than late adulthood.
Marks
Ray
R
City University of New York and Columbia University, New York, NY, USA.
Osteoporos Int. 2009 Apr;20(4):527-36
18766294
Ir Med J. 2008 Jul-Aug;101(7):213-5
18807812
N Z Med J. 2001 Jul 27;114(1136):329-32
11548098
Circulation. 2009 May 5;119(17):2305-12
19380619
J Orthop Surg (Hong Kong). 2006 Dec;14(3):245-8
17200523
Acta Chir Belg. 1999 Aug;99(4):185-9
10499393
J Bone Miner Res. 2009 May;24(5):943-55
19113930
Lancet. 1998 May 2;351(9112):1303-7
9643791
Osteoporos Int. 2001 Dec;12(12):1050-5
11846332
Bone. 1996 Jan;18(1 Suppl):77S-86S
8717551
BMJ. 1993 Nov 13;307(6914):1248-50
8166806
Scand J Rehabil Med Suppl. 1991;24:1-31
1947878
Acta Orthop Traumatol Turc. 2009 May-Jul;43(3):193-8
19717935
Epidemiology. 2000 Mar;11(2):214-9
11021622
Injury. 2009 Feb;40(2):201-4
19100542
Am J Public Health. 2007 Oct;97(10):1734-5
17761556
J Am Geriatr Soc. 1997 Nov;45(11):1302-9
9361654
Rheum Dis Clin North Am. 1990 Aug;16(3):717-40
2217966
Arch Intern Med. 1998 May 11;158(9):990-6
9588432
Am J Epidemiol. 1995 Aug 15;142(4):428-36
7625408
Lancet. 1977 Apr 2;1(8014):726-8
66521
BJU Int. 2007 Oct;100(4):749-54
17822455
JAMA. 1987 Mar 20;257(11):1492-5
3820464
J Am Geriatr Soc. 2008 Apr;56(4):705-10
18005354
Epidemiology. 1998 Jul;9(4):417-23
9647906
J Clin Endocrinol Metab. 2009 Apr;94(4):1207-13
19174498
Clin Interv Aging. 2009;4:153-64
19503777
BMJ. 1989 Oct 7;299(6704):889-92
2510879
Orthop Nurs. 1990 Sep-Oct;9(5):19-30
2216535
Med Hypotheses. 2001 Oct;57(4):469-71
11601871
Clin Orthop Relat Res. 2001 Sep;(390):232-43
11550871
Osteoporos Int. 2006;17(4):552-64
16408148
Osteoporos Int. 1997;7(5):407-13
9425497
Clin Geriatr Med. 1996 Nov;12(4):745-59
8890114
Am J Med. 1998 Jun;104(6):539-45
9674716
JAMA. 1989 May 12;261(18):2663-8
2709546
Osteoporos Int. 1992 Nov;2(6):285-9
1421796
Osteoporos Int. 2005 Oct;16(10):1239-46
15729479
Osteoporos Int. 1999;9(2):188-92
10367048
N Engl J Med. 1991 May 9;324(19):1326-31
2017229
Osteoporos Int. 2000;11(2):134-40
10793871
Injury. 2005 Jan;36(1):88-91; discussion 92
15589923
J Clin Endocrinol Metab. 2001 Jan;86(1):32-8
11231974
Osteoporos Int. 2009 Aug;20(8):1363-7
19009330
Aust N Z J Public Health. 1996 Dec;20(6):579-82
9117962
J Am Geriatr Soc. 2002 Oct;50(10):1644-50
12366617
Clin Biomech (Bristol, Avon). 2009 Feb;24(2):218-24
19091449
J Bone Miner Res. 2004 Apr;19(4):532-6
15005838
Bone. 1999 Feb;24(2):151-5
9951786
N Engl J Med. 1994 Jun 2;330(22):1555-9
8177244
JAMA. 2009 Aug 26;302(8):883-9
19706862
Osteoporos Int. 2006;17(8):1252-7
16680499
J Am Geriatr Soc. 1994 Oct;42(10):1110-7
7930338
Arch Intern Med. 2002 Feb 11;162(3):338-43
11822927
W V Med J. 1999 Jul-Aug;95(4):170-4
10466012
Eur J Radiol. 2009 Sep;71(3):392-7
19716672
Epidemiol Rev. 1985;7:178-208
3902494
Bull World Health Organ. 2001;79(10):942-6
11693976
J Gerontol A Biol Sci Med Sci. 2009 May;64(5):599-609
19264957
Am J Public Health. 2002 May;92(5):858-62
11988460
Am J Public Health. 1997 Mar;87(3):398-403
9096540
Age Ageing. 1995 Nov;24(6):481-4
8588536
J Gerontol A Biol Sci Med Sci. 2009 Feb;64(2):249-55
19196641
J Orthop Trauma. 1996;10(2):99-107
8932668
Arch Phys Med Rehabil. 1987 Oct;68(10):735-40
3662784
Ann Intern Med. 2000 Jul 18;133(2):123-7
10896638
J Bone Miner Res. 2009 Nov;24(11):1808-18
19419312
Calcif Tissue Int. 2009 Jul;85(1):10-6
19533011
Am J Epidemiol. 2001 Jul 1;154(1):60-8
11427405
Bone. 2009 Aug;45(2):246-53
19409518
J Bone Miner Res. 2005 Jul;20(7):1185-94
15940371
Osteoporos Int. 1996;6 Suppl 3:11-5
8931039
Osteoporos Int. 2001;12(4):311-8
11420781
Clin Orthop Relat Res. 2004 Feb;(419):173-8
15021150
Arch Intern Med. 2007 Oct 8;167(18):1971-6
17923597
J Bone Miner Res. 2008 Jan;23(1):143-50
17907920
Bone. 1996 Jan;18(1 Suppl):57S-63S
8717549
N Z Med J. 2001 Apr 13;114(1129):154-6
11400921
Am J Epidemiol. 1998 Nov 1;148(9):887-92
9801019
Obes Res. 1998 Jan;6(1):12-9
9526965
Am J Epidemiol. 1997 May 1;145(9):786-93
9143208
Age Ageing. 1999 Sep;28(5):458-62
10529040
J Clin Nurs. 2009 Nov;18(21):3037-49
19732248
J Bone Miner Res. 1995 Dec;10(12):1900-7
8619370
BMJ. 2006 Jul 1;333(7557):27-30
16809710
Acta Orthop Scand Suppl. 1997 Oct;275:89-91
9385276
Am J Med. 1997 Aug 18;103(2A):12S-17S; discussion 17S-19S
9302893
Osteoporos Int. 1999;9(1):45-54
10367029
Arch Gerontol Geriatr. 2000 Aug 1;31(1):13-18
10989159
Osteoporos Int. 2010 Mar;21(3):409-16
19475474
Med J Aust. 1999 May 17;170(10):467-70
10376021
Injury. 2008 Oct;39(10):1157-63
18653186
Am J Public Health. 2006 Jul;96(7):1210-8
16735617
Osteoporos Int. 1992 Nov;2(6):279-84
1421795
J Geriatr Phys Ther. 2007;30(3):114-20
18171495
Osteoporos Int. 2005 Dec;16(12):2025-30
16133641
J Bone Miner Res. 2001 Mar;16(3):572-80
11277276
Bone. 2006 Sep;39(3):623-7
16603427
J Am Geriatr Soc. 1997 Sep;45(9):1108-12
9288020
Bone. 2002 Jan;30(1):325-30
11792605
Osteoporos Int. 2009 Oct;20(10):1633-50
19421703
Bone. 2009 Jan;44(1):125-9
18848656
Osteoporos Int. 2009 May;20(5):687-94
18797813
Clin Orthop Relat Res. 1980 Oct;(152):185-90
7438602
Am J Orthop (Belle Mead NJ). 1996 Mar;25(3):198-204
8775696
Wien Med Wochenschr. 2009 May;159(9-10):221-9
19484204
Osteoporos Int. 2007 May;18(5):585-91
17146592
J Orthop Trauma. 1997 Apr;11(3):162-5
9181497
Curr Osteoporos Rep. 2003 Sep;1(2):78-85
16036069
Osteoporos Int. 2009 Nov;20(11):1853-61
19347239
Acta Orthop Scand. 1983 Apr;54(2):198-203
6845994
JAMA. 1994 Jan 12;271(2):128-33
8264067
Lancet. 2002 May 18;359(9319):1761-7
12049882
Ups J Med Sci. 1989;94(2):209-21
2763393
Am J Orthop (Belle Mead NJ). 2005 May;34(5):252-5
15954693
J Am Geriatr Soc. 1989 Jan;37(1):9-16
2909610
J Bone Miner Metab. 2008;26(4):400-5
18600408
Bone. 1996 Mar;18(3 Suppl):121S-125S
8777076
Osteoporos Int. 2002 Jan;13(1):18-25
11878451
Osteoporos Int. 2009 Jul;20(7):1117-29
19048180
Osteoporos Int. 2005 Nov;16(11):1330-8
15928804
Am J Epidemiol. 1996 Jul 15;144(2):124-34
8678043
J Bone Miner Res. 2008 Jul;23(7):1037-44
18302496
J Bone Miner Res. 1997 Nov;12(11):1895-902
9383694
Med Eng Phys. 1998 Jan;20(1):57-65
9664286
J Am Geriatr Soc. 1994 Jul;42(7):774-8
8014355
Lancet. 1999 Mar 6;353(9155):802-5
10459962
Southeast Asian J Trop Med Public Health. 2001 Mar;32(1):196-203
11485085
Osteoporos Int. 2000;11(12):1018-23
11256892
J Public Health Med. 1999 Sep;21(3):249-50
10528950
Am J Epidemiol. 1994 Nov 1;140(9):830-8
7977293
Arch Gerontol Geriatr. 2010 May-Jun;50(3):e13-8
19481270
Am J Epidemiol. 1996 Apr 1;143(7):677-82
8651229
Ugeskr Laeger. 2008 Feb 18;170(8):621-3
18367043
J Am Med Dir Assoc. 2008 Feb;9(2):114-9
18261704
Rehabilitation (Stuttg). 1999 Aug;38(3):160-9
10507090
Calcif Tissue Int. 1998 Apr;62(4):366-9
9504964
Am J Epidemiol. 2000 Oct 1;152(7):633-9
11032158
Int J Epidemiol. 1998 Oct;27(5):860-5
9839744
BMJ. 1988 Dec 3;297(6661):1443-6
3147008
J Clin Psychopharmacol. 2008 Aug;28(4):384-91
18626264
Osteoporos Int. 2010 Mar;21(3):399-408
19484169
Am J Med. 1997 Aug 18;103(2A):51S-63S; discussion 63S-64S
9302897
Bone. 2007 May;40(5):1284-9
17292683
Osteoporos Int. 1994;4 Suppl 1:67-70
8081063
Osteoporos Int. 2005 Dec;16(12):2185-94
16177836
Age Ageing. 1995 Mar;24(2):96-8
7793343
J Gerontol A Biol Sci Med Sci. 2009 Mar;64(3):403-10
19196903
Ann Epidemiol. 2008 Nov;18(11):836-41
18940632
Food Nutr Res. 2008;52:
19158939
Osteoporos Int. 1997;7(6):503-13
9604045
Injury. 2002 Jun;33(5):387-91
12095716
J Rheumatol. 1995 May;22(5):921-5
8587083
J Am Geriatr Soc. 1998 Feb;46(2):169-73
9475444
Calcif Tissue Int. 1998 Jun;62(6):542-7
9576984
Clin Orthop Relat Res. 1984 Jul-Aug;(187):215-7
6744720
Am J Epidemiol. 1997 Sep 15;146(6):502-9
9290511
Bone. 2008 Feb;42(2):278-85
18037366
Osteoporos Int. 2005 Dec;16(12):1963-8
16133645
Am J Epidemiol. 1991 Nov 15;134(10):1128-37
1746523
Aging Clin Exp Res. 2008 Aug;20(4):344-8
18852548
Am J Epidemiol. 1996 Nov 1;144(9):901-7
8890668
J Gerontol A Biol Sci Med Sci. 1999 Dec;54(12):M635-40
10647970
J Am Geriatr Soc. 1990 Oct;38(10):1139-44
2172352
Aging Clin Exp Res. 2008 Oct;20(5):412-8
19039282
Clin Orthop Relat Res. 1993 Apr;(289):166-9
8472408
J Am Geriatr Soc. 1989 Jun;37(6):495-500
2715555
Osteoporos Int. 2007 Sep;18(9):1279-85
17440675
Bone. 2008 Nov;43(5):941-4
18656561
J Bone Joint Surg Am. 2009 Mar 1;91(3):503-11
19255209
N Engl J Med. 1995 Mar 23;332(12):767-73
7862179
J Bone Miner Metab. 2001;19(6):378-81
11685654
Osteoporos Int. 2001;12(9):763-8
11605743
Curr Opin Pharmacol. 2002 Jun;2(3):330-7
12020479
Age Ageing. 1992 Jan;21(1):32-8
1553857
Bone. 1996 Jan;18(1 Suppl):87S-101S
8717552
J Bone Miner Res. 2008 Nov;23(11):1825-31
18665785
J Gerontol. 1989 Jul;44(4):M107-11
2738306
J Epidemiol Community Health. 1993 Dec;47(6):441-3
8120496
Br Med J (Clin Res Ed). 1986 Mar 29;292(6524):861-3
3083912
Clin Geriatr Med. 1993 Feb;9(1):69-86
8443741
J Am Geriatr Soc. 1992 Sep;40(9):861-6
1512379
Osteoporos Int. 2005 Mar;16 Suppl 2:S8-S17
15378232
J Bone Joint Surg Am. 2008 Feb;90(2):241-8
18245581
Osteoporos Int. 2008 Aug;19(8):1139-45
18087659
Aging Clin Exp Res. 2008 Oct;20(5):434-8
19039285
Ir J Med Sci. 2001 Jan-Mar;170(1):49-53
11440414
Bone. 1999 Mar;24(3):257-9
10071919
Ig Sanita Pubbl. 2008 Sep-Oct;64(5):623-36
19188938
Clin Orthop Relat Res. 1995 Feb;(311):129-35
7634567
Osteoporos Int. 2006;17(3):464-70
16283063
Acta Clin Belg. 1993;48(3):190-4
8396300
Osteoporos Int. 2001;12(3):239-43
11315243
Clin Calcium. 2008 Jun;18(6):747-53
18515942
J Bone Miner Res. 2010 Jan;25(1):64-71
19580459
Br J Rheumatol. 1996 Dec;35(12):1299-304
9010060
BMC Geriatr. 2008 Dec 23;8:35
19105814
Am J Med. 1997 Oct;103(4):274-80
9382119
J Clin Endocrinol Metab. 2009 Feb;94(2):491-6
19017753
Lancet. 1985 Jan 19;1(8421):150-1
2857223
Accid Anal Prev. 1998 Sep;30(5):607-16
9678214
Eur J Epidemiol. 2008;23(11):747-55
18830674
BMJ. 2005 Dec 10;331(7529):1374
16299013
Bone. 1996 Jan;18(1):19-22
8717532
J Gerontol. 1990 May;45(3):M101-7
2335719
Clin Geriatr Med. 2008 Nov;24(4):701-19, ix
18984382
Eur J Epidemiol. 2009;24(8):441-8
19484362
J Am Geriatr Soc. 2003 Mar;51(3):356-63
12588579
Age Ageing. 1996 Mar;25(2):97-101
8670535
Age Ageing. 2009 Jul;38(4):429-34
19406974
Injury. 2009 Jul;40(7):722-6
19426972
J Bone Miner Res. 2009 Jul;24(7):1299-307
19257816
Age Ageing. 1996 Jul;25(4):322-5
8831880
Am J Public Health. 1988 Dec;78(12):1554-8
3189632
Ginekol Pol. 2001 Dec;72(12A):1388-92
11883284
J Gerontol. 1994 Jul;49(4):S165-75
8014400
J Orthop Sci. 2007 Mar;12(2):113-7
17393264
Tohoku J Exp Med. 1999 Jun;188(2):139-42
10526875
Calcif Tissue Int. 2001 Jun;68(6):337-41
11685420
J Biomech. 1999 Sep;32(9):993-8
10460138
Osteoporos Int. 2009 Dec;20(12):2105-10
19337676
Wien Klin Wochenschr. 2001 May 15;113(10):371-7
11432126
Acta Orthop Scand. 1991 Jun;62(3):208-17
2042461
Osteoporos Int. 2008 Dec;19(12):1741-7
18484149
Am J Med. 1997 Aug 18;103(2A):65S-71S; discussion 71S-73S
9302898
J Bone Miner Res. 1998 Jun;13(6):918-24
9626622