title: Trends in fracture incidence: a population-based study over 20 years.
abstract: To assess recent trends in fracture incidence from all causes at all skeletal sites, we used the comprehensive (inpatient and outpatient) data resources of the Rochester Epidemiology Project to estimate rates for Olmsted County, MN, USA, residents in 2009 to 2011 compared with similar data from 1989 to 1991. During the 3-year study period, 2009 to 2011, 3549 residents ≥50 years of age experienced 5244 separate fractures. The age- and sex-adjusted (to the 2010 US white population) incidence of any fracture was 2704 per 100,000 person-years (95% confidence interval [CI] 2614 to 2793) and that for all fractures was 4017 per 100,000 (95% CI 3908 to 4127). Fracture incidence increased with age in both sexes, but age-adjusted rates were 49% greater among the women. Overall, comparably adjusted fracture incidence rates increased by 11% (from 3627 to 4017 per 100,000 person-years; p = 0.008) between 1989 to 1991 and 2009 to 2011. This was mainly attributable to a substantial increase in vertebral fractures (+47% for both sexes combined), which was partially offset by a decline in hip fractures (-25%) among the women. There was also a 26% reduction in distal forearm fractures among the women; an increase in distal forearm fractures among men aged 50 years and over was not statistically significant. The dramatic increase in vertebral fractures, seen in both sexes and especially after age 75 years, was attributable in part to incidentally diagnosed vertebral fractures. However, the fall in hip fracture incidence, observed in most age groups, continues the steady decline observed among women in this community since 1950. More generally, these data indicate that the dramatic increases in the incidence of fractures at many skeletal sites that were observed decades ago have now stabilized.
authors: Division of Rheumatology, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA; Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN, USA.
authors: Shreyasee
authors: S
authors: Amin
authors: Sara J
authors: SJ
authors: Achenbach
authors: Elizabeth J
authors: EJ
authors: Atkinson
authors: Sundeep
authors: S
authors: Khosla
authors: L Joseph
authors: LJ
authors: Melton
mesh_terms: D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance
keywords: EPIDEMIOLOGY; FRACTURE; INCIDENCE; OSTEOPOROSIS; SECULAR TRENDS
references: Arch Intern Med. 2004 Jul 26;164(14):1525-30
references: 15277283
references: Osteoporos Int. 2000;11(7):577-82
references: 11069191
references: Osteoporos Int. 2012 Feb;23(2):771-80
references: 21625885
references: J Epidemiol Community Health. 1990 Sep;44(3):241-5
references: 2273364
references: Osteoporos Int. 1998;8(4):341-8
references: 10024904
references: Injury. 2005 Nov;36(11):1323-9
references: 15979626
references: J Bone Miner Res. 2012 Nov;27(11):2325-32
references: 22692958
references: Int J Epidemiol. 2012 Dec;41(6):1614-24
references: 23159830
references: Osteoporos Int. 2013 Mar;24(3):801-10
references: 23208073
references: Bone. 2001 Dec;29(6):517-22
references: 11728921
references: J Bone Miner Res. 2008 Jul;23(7):1061-7
references: 18302495
references: Osteoporos Int. 2011 Jul;22(7):2137-43
references: 21069292
references: N Engl J Med. 1997 Nov 13;337(20):1466-70
references: 9380105
references: Inj Prev. 2007 Aug;13(4):243-7
references: 17686934
references: Osteoporos Int. 2009 Nov;20(11):1969-72
references: 19184268
references: J Bone Miner Res. 2009 Sep;24(9):1512-4
references: 19708768
references: Osteoporos Int. 2004 Aug;15(8):603-10
references: 15004666
references: Am J Epidemiol. 2011 May 1;173(9):1059-68
references: 21430193
references: Am J Med. 2007 May;120(5):381-7
references: 17466644
references: Osteoporos Int. 2010 Jan;21(1):35-40
references: 19705047
references: Am J Med. 2009 Feb;122(2 Suppl):S14-21
references: 19187808
references: JAMA. 2009 Oct 14;302(14):1573-9
references: 19826027
references: Mayo Clin Proc. 2012 Dec;87(12):1202-13
references: 23199802
references: J Bone Joint Surg Am. 2011 Jan 19;93(2):121-31
references: 21248210
references: J Gerontol A Biol Sci Med Sci. 2007 Feb;62(2):180-3
references: 17339643
references: Osteoporos Int. 2010 Jan;21(1):25-33
references: 19705048
references: Acta Orthop. 2009 Oct;80(5):520-4
references: 19916682
references: Bone. 2008 Aug;43(2):340-2
references: 18538645
references: J Bone Miner Res. 1992 Feb;7(2):221-7
references: 1570766
references: Osteoporos Int. 2009 May;20(5):687-94
references: 18797813
references: Osteoporos Int. 2007 May;18(5):585-91
references: 17146592
references: Injury. 2012 Apr;43(4):458-61
references: 22055140
references: Osteoporos Int. 2012 Jun;23(6):1721-6
references: 21909727
references: Am J Health Syst Pharm. 2009 Jul 1;66(13):1191-201
references: 19535658
references: Calcif Tissue Int. 1992 Aug;51(2):100-4
references: 1422947
references: Am J Orthop (Belle Mead NJ). 2005 May;34(5):252-5
references: 15954693
references: Osteoporos Int. 2011 May;22(5):1277-88
references: 21461721
references: Osteoporos Int. 2010 Mar;21(3):399-408
references: 19484169
references: J Bone Miner Res. 2005 Jun;20(6):898-905
references: 15883628
references: Menopause. 2009 Jan-Feb;16(1):77-83
references: 18703983
references: Acta Orthop Scand. 1999 Apr;70(2):129-32
references: 10366911
references: J Bone Miner Res. 2007 Mar;22(3):465-75
references: 17144789
references: Osteoporos Int. 1999;9(1):29-37
references: 10367027
references: Bone. 2010 May;46(5):1355-8
references: 19945550
references: J Bone Miner Res. 2005 Apr;20(4):557-63
references: 15765173
references: Injury. 2007 Jan;38(1):81-3
references: 17083943
references: Osteoporos Int. 1999;10(3):214-21
references: 10525713
references: J Clin Epidemiol. 2008 Dec;61(12):1250-1260
references: 18619800
references: Calcif Tissue Int. 1989 Mar;44(3):157-67
references: 2493320
references: Osteoporos Int. 2005 Mar;16(3):306-12
references: 15455193
references: Bone. 2009 Apr;44(4):656-9
references: 19135560
references: Osteoporos Int. 1993 May;3(3):127-32
references: 8481588