title: Continued decline in hip fracture incidence in Norway: a NOREPOS study.
abstract: The previously reported decline in age-adjusted hip fracture rates in Norway during 1999-2008 continued after 2008. The annual number of hip fractures decreased in women and increased in men.
  
  
  
  Norway has among the highest hip fracture incidence rates ever reported despite previously observed declining rates from 1999 through 2008. The aim of the present study was to investigate whether this downward trend continued through 2013, and to compare gender-specific trends in 5 year age-groups during three time periods: 1999-2003, 2004-2008, and 2009-2013.
  
  
  
  All hip fractures (cervical, trochanteric, and sub-trochanteric) admitted to Norwegian hospitals were retrieved. Annual age-standardized incidence rates of hip fracture per 10,000 person-years by gender were calculated for the period 1999-2013. Time trends were tested by age-adjusted Poisson regression.
  
  
  
  From 1999 through 2013 there were 140,136 hip fractures in persons aged 50 years and above. Age-adjusted hip fracture incidence rates declined by 20.4 % (95 % CI: 18.6-20.1) in women and 10.8 % (95 % CI: 7.8-13.8) in men, corresponding to an average annual age-adjusted decline of 1.5 % in women and 0.8 % in men. Except for the oldest men, hip fracture rates declined in all age-groups 70 years and older. The average annual number of fractures decreased in women (-0.3 %) and increased in men (+1.1 %).
  
  
  
  During the past 15 years, hip fracture rates have declined in Norway. The forecasted growing number of older individuals might, however, cause an increase in the absolute number of fractures, with a substantial societal economic and public health burden.
authors.affiliation: Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway. anne.johanne.sogaard@fhi.no.
authors.forename: A J
authors.initials: AJ
authors.lastname: Søgaard
authors.affiliation: Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Holvik
authors.affiliation: Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway.|Institute of Health and Society, University of Oslo, 0318, Oslo, Norway.
authors.forename: H E
authors.initials: HE
authors.lastname: Meyer
authors.affiliation: Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway.|Department of Global Public Health and Primary Care, University of Bergen, 5020, Bergen, Norway.
authors.forename: G S
authors.initials: GS
authors.lastname: Tell
authors.affiliation: Department of Clinical Science, University of Bergen, 5020, Bergen, Norway.|Department of Rheumatology, Haukeland University Hospital, 5021, Bergen, Norway.
authors.forename: C G
authors.initials: CG
authors.lastname: Gjesdal
authors.affiliation: Department of Health and Care Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway.
authors.forename: N
authors.initials: N
authors.lastname: Emaus
authors.affiliation: Department of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway.|Division of Internal Medicine, University Hospital of North Norway Tromsø, 9038, Tromsø, Norway.
authors.forename: G
authors.initials: G
authors.lastname: Grimnes
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, 7491, Trondheim, Norway.|Department of Obstetrics and Gynecology, St. Olavs Hospital, 7005, Trondheim, Norway.
authors.forename: B
authors.initials: B
authors.lastname: Schei
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, 7491, Trondheim, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Forsmo
authors.affiliation: Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway.|Institute of Health and Society, University of Oslo, 0318, Oslo, Norway.
authors.forename: T K
authors.initials: TK
authors.lastname: Omsland
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005544:Forecasting; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology
keywords: Age; Gender; Hip fracture; Incidence; Trend