title: Secular trends of hip fractures in Québec, Canada.
abstract: This study examined the secular trends of hip fracture incidence among individuals 50 years and older in Québec between 1993 and 2004. Age-standardized rates decreased at both the provincial and regional levels. The largest relative decrease was observed among younger females, and rates declined more slowly in the elderly.
  
  
  BACKGROUND
  The population of the province of Québec is among the oldest in North America. Before the trend rupture reported in the late 1990s in several countries, hip fracture (HF) incidence rates did not show a secular trend (between 1981 and 1992). This study examined the secular trends of HF incidence at the provincial level and in two of the most important urban areas of the province, Montréal and Québec City, between 1993 and 2004.
  
  
  METHODS
  All hospitalisations of individuals 50 years and older living in the province of Québec between 1993 and 2004 with a main diagnosis of HF were included. Standardized rates of HF incidence were calculated for females and males, 50-74 years and 75 years and older.
  
  
  RESULTS
  The Québec City area showed a strong decreasing trend in HF rates for younger females, but the other groups did not show an obvious trend. Although our models did not support the existence of significant differences in trends between both areas, the rates of HF of younger males and, to a lesser extent, of older women in the Montréal area were significantly higher than in the Québec City area.
  
  
  CONCLUSIONS
  Differences observed in hip fracture rates as well as in secular trends between age groups and gender emphasise the need for decision makers to rely on results based on age-specific and sex-specific analyses.
authors.affiliation: Groupe de recherche Primus, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001, 12e avenue nord, Sherbrooke, QC, J1H 5N4, Canada. alain.vanasse@usherbrooke.ca
authors.forename: A
authors.initials: A
authors.lastname: Vanasse
authors.forename: M G
authors.initials: MG
authors.lastname: Orzanco
authors.forename: P
authors.initials: P
authors.lastname: Dagenais
authors.forename: T
authors.initials: T
authors.lastname: Ouarda
authors.forename: J
authors.initials: J
authors.lastname: Courteau
authors.forename: S
authors.initials: S
authors.lastname: Asghari
authors.forename: F
authors.initials: F
authors.lastname: Chebana
authors.forename: B
authors.initials: B
authors.lastname: Martel
authors.forename: P
authors.initials: P
authors.lastname: Gosselin
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011792:Quebec / Q000453:epidemiology; D017678:Sex Distribution; D014504:Urban Health / Q000706:statistics & numerical data*