Lifetime fracture risks estimated for Canadians
MedWire News: Approximately one in ten women and one in twenty men who are 50 years of age will experience a hip fracture during the remainder of their lifetime, Canadian researchers have estimated.
These rates are lower than the last lifetime fracture risk estimates, which were made in 1989, when the lifetime risk for hip fractures in Canada was 14.0% for women and 5.2% for men, note Robert Hopkins (McMaster University, Hamilton, Ontario) and colleagues.
The researchers explain that lifetime estimates for fracture risk are required to build economic models for evaluating the cost-effectiveness of strategies to reduce hip fracture incidence.
Since the 1989 estimates, there have been changes in rates of hip fracture, increased longevity, and changes in the levels of risk factors such as tobacco and alcohol use, and the rate of obesity, which is a protective factor.
Hopkins and team therefore updated these estimates to 2008 for men and women beginning at age 50 years. They then adjusted them for current trends in mortality and hip fracture rates, and estimated the lifetime risk for first hip fracture by adjusting for the rate of recurrent fractures.
National administrative data showed that between April 2007 and March 2008, 21,687 hip fractures occurred in Canadian men and women. As expected, the majority of cases (72.6%) were in women.
Using a life tables method, the researchers calculated that the crude lifetime risk was 12.1% for women and 4.6% for men.
Adjusting for the current declining trends in mortality and hip fractures gave lifetime risks of 8.9% and 6.7%, for women and men respectively, while the risks for a first fracture were 7.3% and 6.2%.
"Statistics Canada predicts that the population over age 80 years will increase by an average rate of 6.4% per year until the year 2041," Hopkins et al note.
This means that while the rate of hip fractures have generally been declining for women and men, there will be a rise in the absolute numbers of hip fractures.
"If the risk of hip fracture can continue to decline… some mitigation of the burden due to the increased numbers of hip fracture arising from an aging population may occur," the team concludes in the journal Osteoporosis International.
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By Laura Dean