Healthcare professional helps senior woman walk with a walker

Hip fracture prevalence is trending downward in countries and regions around the world, a new study has found. But the decreases will not compensate for the global impact of aging populations, experts say. The total number of these fractures is projected to almost double worldwide by 2050 compared to 2018, experts estimate.

The estimates come from an international group of researchers, who examined trends in hip fracture incidence, post-fracture treatment and all-cause mortality across 19 countries and 5 regions from 2005 to 2018.

The greatest declines in sex- and age-standardized incidence rates during that period were in Denmark (‐2.8% per year), Singapore (‐2.8%) and Hong Kong (‐2.4%), while the greatest increases were in the Netherlands (+2.1%), and South Korea (+1.2%), researchers reported in the Journal of Bone and Mineral Research.

Notably, post-fracture preventive treatment for osteoporosis was lacking for both sexes across all countries and regions, particularly in men, the investigators found. Within 1 year following a hip fracture, post-fracture treatment overall ranged from 11% in Germany to 50% in the United Kingdom. Males had lower use of anti-osteoporosis medication than females, and higher rates of all-cause mortality related to their fractures, the researchers noted.

Meanwhile, the number of hip fractures worldwide is projected to skyrocket by 2050, with males having a larger increase in the projected number of hip fractures by that time. The estimates were based on the trends in incidence rates and World Bank data.

The findings highlight an urgent need for improvements in hip fracture prevention and care, said professor Cyrus Cooper, president of the International Osteoporosis Foundation and a co-author of the study. Cooper added that he found the overall lack of osteoporosis treatment unacceptable.

“This should be seen as both a warning and a call to action for healthcare systems worldwide,” he said.

The first step to tackling the problem, he said, is prioritizing the implementation of post-fracture care coordination programs such as the Fracture Liaison Service from the Bone Health & Osteoporosis Foundation, a program that is available in the United States.

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