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Study Shows Hip Fracture Underestimated as Public Health Threat

Topping the list of current public health threats are lifestyle habits like smoking, overeating and lack of exercise that lead to illness and premature deaths from heart disease, cancer and diabetes. Fast forward a decade or two and other types of health problems will start to loom large as more and more Americans live past 85 years of age. One of those concerns will very likely be the incidence of hip fracture. As with any public health concern, the better prepared the healthcare community is, the better equipped it will be to find ways to prevent an epidemic.

Currently, hip fractures represent one of the greatest pubic health risks facing seniors in this country resulting in disability and loss of independence and in worst cases, death. With as many as 250,000 fractures a year, it is the fourth leading cause of hospitalization for people 85 and older. As the American population 85 and older continues to grow, the incidence of hip fracture will likely grow with it. Epidemiologists estimate that by 2040 the annual number of hip fractures will more than double unless measures are taken to reduce the risk. However, this estimate is based on the assumption that the rate of hip fracture in people over 85 remains stable.

In a paper, recently published in the American Journal of Public Health, researchers, including faculty from Hebrew Rehabilitation Center for Aged’s Research & Training Institute, reported the results of a study that revealed a trend indicating hip fracture rates might rise over the next couple of decades. Their study examined participants from the Framingham Heart Study, a population whose medical history has been followed since 1948. The investigators looked at medical records on this group to find out if the rate of hip fracture varied depending on when an individual was born, or in other words, by birth cohort.

Analysis of data showed that, for a given age, the rate of hip fracture actually increased progressively from the oldest to the youngest cohort. For example, a person 85 years old who was born in 1911 is more likely to suffer a fracture than an 85 year-old born in 1901. This trend, coupled with the increase in life expectancy for each successive birth cohort, has major implications for accurately predicting what the public health burden of hip fracture will be in the future.

“The results of this study must be considered in order for public health professionals to plan for the tremendous social, economic, and medical costs associated with hip fracture. Otherwise, projections will seriously underestimate the future impact of hip fracture in the United States,” says Elizabeth Samelson, Ph.D., M.P.H., principal investigator on the study.

In addition to Dr. Samelson, Research & Training Institute researchers on this study included Marian T. Hannan, D.Sc., M.P.H. and Douglas P. Kiel, M.D., M.P.H., director of Medical Research.