Trends in fracture incidence: A population-based study over 20 years

Journal of Bone and Mineral Research, 08/21/2013

To assess recent trends in fracture incidence from all causes at all skeletal sites, the authors used the comprehensive (inpatient and outpatient) data resources of the Rochester Epidemiology Project to estimate rates for Olmsted County, Minnesota, residents in 2009–1, compared to similar data from 1989–1. 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.

  • During the three–year study period, 2009–11, 3549 residents ≥ 50 years of age experienced 5244 separate fractures.
  • The age– and sex–adjusted (to the 2010 United States white population) incidence of any fracture was 2704 per 100,000 person–years (95% CI 2614–2793) and that for all fractures was 4017 per 100,000 (95% CI 3908–4127).
  • 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 1989–1 and 2009–2011.
  • This was mainly due 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 age 50 years and over was not statistically significant.

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