Has the Risk of Hip Fracture Changed over Time? Save

Data from the Framingham Heart Study has shown that hip fracture incidence has decreased over time, probably resulting from improved lifestyle changes (less smoking and heavy drinking). 

The incidence of hip fracture has been shown to be decreasing in the US, presumeably attributeable to better osteoporosis treatment and care. This study examined the hip fracture incidence over the past 40 years in the US.

From a total of 10 552 individuals followed for over 40 years,  4918 men and 5634 women were followed prospectively till their first hip fracture between 1970 and 2010. 

Adjusted for age, the incidence of hip fracture decreased by 4.4% per year from 1970 to 2010. Reducing risks were significantly linked with period (P < .001) and birth cohort associations (P < .001)

This decrease in hip fracture incidence was coincident with a decrease in smoking and heavy drinking. Smoking decreased from 38% in the 1970s to 15% in the late 2000s, while heavy drinking decreased from 7.0% to 4.5%.  Other risk factors for hip fracture (underweight, obesity and early menopause) were stable over the study period.

Persons born more recently appeared to have a low risk for hip fracture. This was coincident with reductions in smoking and heavy drinking. Thus better OP treatment is not sole reason for improved fracture rates over time.