Good News about Hip Fracture Rates

As many as 15% to 25% of older people who sustain a fracture of the hip will die within a year. Illness and disability after such a fracture are related to immobility, and include deep vein thrombosis, pulmonary embolism, pneumonia, and muscular deterioration. This depressing picture is slightly ameliorated by a recent study from Canada, showing that the frequency of hip fracture in that country is decreasing. It’s published in the Journal of the American Medical Association.  

Nationwide hospitalization data for 1985 to 2005 from a database at the Canadian Institute of Health Information were analyzed. There were over 575,000 cases of hip fracture.

Over the 21-year period, age-adjusted hip fracture rates decreased by 31% in women and by 25% in men. Overall, there was a 1.2% per year decrease from 1985 to 1996, and 2.4% per year from 1996 to 2005. It’s possible that the accelerated decrease was related to the introduction of bisphosphonate drugs (Fosamax® and friends) in the mid-1990s. But there was a pronounced decrease before 1996.

Interestingly, a similar decrease in the rate of hip fractures was reported for the USA in 2007, but it attracted little notice. Over an 11-year period (1993-2003) there was a 20% decrease in age-adjusted hip fracture rate for men and women.

The likely causes for this decline in fracture rates probably include increased use of bisphosphonates to prevent worsening of osteoporosis, greater efforts to make homes (and nursing homes) fall-proof, increasing mobility and exercise in older persons, improved nutrition, and more balance (Tai Chi) classes. However, none of these are fully tested for their contribution to reducing hip fractures. We can report that wearing hip protectors is not helpful.