Hip fractures to double globally as populations grow frailer
HIP fractures will nearly double worldwide within 30 years, according to a new study.
Already a dangerous and debilitating problem for older men and women worldwide, doctors have warned that it is poised to become a “far more severe” global public health issue as the world’s population grows older and frailer.
Researchers say the risk is particularly severe among men and those over 85.
The team analysed data from 19 countries for patients 50 and older who had fractured their hips between 2005 and 2018.
They found that total hip fracture counts were expected to increase over time in 18 of the 19 countries.
Hip fracture counts were projected by 2030 and 2050 using predicted population size provided by the World Bank.
By 2050, the worldwide hip fracture counts will have likely doubled compared with 2018 – with a larger proportional increase in men than women, according to the findings.
The research team said one of the reasons for the sex discrepancy may be that although the incidence of hip fractures declined in most countries during the study period, the magnitude of decline was smaller for men.
Meanwhile, men’s life expectancy has been increasing as a result of better medical care, hygiene, diet, and other factors.
The United Nations projects that the life expectancy of men globally will likely reach over 75 by 2050, the age after which the study showed a high risk of hip fracture.
Osteoporosis – or brittle bones – has been underdiagnosed in men and undertreated for many years, according to the research team. Research leader Dr Chinglung Cheung said: “Our study also showed that the use of antiosteoporosis medications following a hip fracture is lower in men than in women by 30 per cent to 67%.”
Dr Cheung, associate professor in the University of Hong Kong’s Department of Pharmacology and Pharmacy, added: “More attention should be paid to preventing and treating hip fractures in men.”
The researchers found “wide variability” among the 19 countries studied. The overall age and sex-standardised incidence of hip fracture was estimated to be 180 per 100,000 individuals, with the figure 236 among women and 118 in men.
But the average change in hip fracture incidence varied from -2.8% to +2.1% per year.
The most pronounced declines in fractures were seen in Denmark, Singapore (both -2.8%), and Hong Kong (-2.4%).
The biggest increases were in the Netherlands (+2.1%) and South Korea (+1.2%).
Study co-author Dr ChorWing Sing believes the reasons for the observed variability among countries would require further in-depth research.
Dr Sing, a research assistant professor at the University of Hong Kong, said: “One potential reason that some countries have seen relatively large declines in hip fractures is better osteoporosis management and post-fracture care.
“Better fall-prevention programmes and clearer guidelines for clinical care have likely made a difference.”
Dr Sing also noted people’s greater awareness of bone health, resulting in an increase in bone mineral density, or BMD, may also have helped, she suggested.
She cited a study in Hong Kong, which had one of the largest falls in hip fractures, which showed that women aged 50 and older had become more physically active and started doing more weight-bearing exercise, resulting in a significant long-term increase of BMD.