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Epidemiology of fractures in Iceland and secular trends in major osteoporotic fractures 1989–2008

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An Erratum to this article was published on 22 October 2013

Abstract

Summary

The incidence of the most common fracture types in Iceland is reported based on individual data from the Reykjavik Study 1967–2008. Time trend is reported for the major osteoporotic fractures (MOS) 1989–2008.

Introduction

This study aims to assess the incidence of all fractures in Iceland, with emphasis on the rate of hip fractures, and compare the incidence with other populations as well as examine the secular changes.

Methods

Individuals from the prospective population-based cohort Reykjavik Study were examined between 1967 and 2008 (follow-up 26.5 years), which consisted of 9,116 men and 9,756 women born in 1907–1935, with age range 31–81 years. First fracture incidence was estimated using life table methods with age as the timescale.

Results

Fracture rate increased proportionally with age between the sexes for vertebral and proximal humerus but disproportionally for hip and distal forearm fractures. The ratio of first fracture incidence between the sexes varied considerably by site: 2.65 for hip fractures and the highest for distal forearm fractures at 4.83. By the age of 75, 36.7 % of women and 21 % of men had sustained a fracture, taking into account competing risk of death. The incidence of hip fractures was similar to results previously published from USA, Sweden, Norway, and Scotland. The incidence of MOS fractures in both sexes decreased over the last decade, except hip fractures in men, which remained unchanged, as reflected in the women/men ratio for the hip, which changed from 2.6 to 1.7.

Conclusion

This study adds information to scarce knowledge on the relative fracture incidence of different fractures. The incidence of MOS fractures increased in the latter part of the last century in both sexes and declined during the last decade, less dramatically for men. This information is important for planning health resources.

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References

  1. Johnell O, Kanis JA (2004) An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporos Int 15:897–902

    Article  CAS  PubMed  Google Scholar 

  2. Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733

    Article  CAS  PubMed  Google Scholar 

  3. Ström O, Borgström F, Kanis JA, Compston J, Cooper C, McCloskey EV, Jönsson B (2011) Osteoporosis: burden, health care provision and opportunities in the EU. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 6:59–155

    Article  PubMed  Google Scholar 

  4. Melton LJ 3rd, Crowson CS, O'Fallon WM (1999) Fracture incidence in Olmsted County, Minnesota: comparison of urban with rural rates and changes in urban rates over time. Osteoporos Int 9:29–37

    Article  PubMed  Google Scholar 

  5. Kanis JA, Johnell O, Oden A, Sernbo I, Redlund-Johnell I, Dawson A et al (2000) Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int 11:669–674

    Article  CAS  PubMed  Google Scholar 

  6. van Staa TP, Dennison EM, Leufkens HG, Cooper C (2001) Epidemiology of fractures in England and Wales. Bone 29:517–522

    Article  PubMed  Google Scholar 

  7. Donaldson LJ, Reckless IP, Scholes S, Mindell JS, Shelton NJ (2008) The epidemiology of fractures in England. J Epidemiol Community Health 62:174–180

    Article  CAS  PubMed  Google Scholar 

  8. Kanis JA, Oden A, McCloskey EV, Johansson H, Wahl DA, Cooper C et al (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23:2239–2256

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. http://www.who.int/reproductivehealth/publications/ageing/9241208430/en/index.html Accessed 26 July 2012

  10. Delmas PD, Marin F, Marcus R, Misurski DA, Mitlak BH (2007) Beyond hip: importance of other nonspinal fractures. Am J Med 120:381–387

    Article  CAS  PubMed  Google Scholar 

  11. Robertsson GO, Jonsson GT, Sigurjonsson K (1990) Epidemiology of distal radius fractures in Iceland in 1985. Acta Orthop Scand 61:457–459

    Article  CAS  PubMed  Google Scholar 

  12. Schwartz AV, Kelsey JL, Maggi S, Tuttleman M, Ho SC, Jonsson PV et al (1999) International variation in the incidence of hip fractures: cross-national project on osteoporosis for the World Health Organization Program for Research on Aging. Osteoporos Int 9:242–253

    Article  CAS  PubMed  Google Scholar 

  13. Jonsson BY, Siggeirsdottir K, Mogensen B, Sigvaldason H, Sigursson G (2004) Fracture rate in a population-based sample of men in Reykjavik. Acta Orthop Scand 75:195–200

    Article  PubMed  Google Scholar 

  14. Bjornsson OJ, Davidsson D, Olafsson H, Olafsson O, Sigfusson N, Thorsteinsson Th (1979) Report XVIII. Health survey in the Reykjavik area—men. Stages I–III, 1967–1968, 1970–1971 and 1974–1975. Participants, invitation, response etc. The Icelandic Heart Association, Reykjavik, Iceland

  15. Bjornsson G, Bjornsson OJ, Davidsson D, Kristjansson B Th, Olafsson O, Sigfusson N, Thorsteinsson Th (1982) Report abc XXIV. Health survey in the Reykjavik area—women. Stages I–III, 1968–1969, 1971–1972 and 1976–1978. Participants, invitation, response etc. The Icelandic Heart Association, Reykjavik, Iceland

  16. World Health Organization (2012) International statistical classification of diseases and related health problems, 10th revision. http://www.who.int/classifications/icd/en/ Accessed April 15

  17. Siggeirsdottir K, Aspelund T, Sigurdsson G, Mogensen B, Chang M, Jonsdottir B et al (2007) Inaccuracy in self-report of fractures may underestimate association with health outcomes when compared with medical record based fracture registry. Eur J Epidemiol 22:631–639

    Article  PubMed  Google Scholar 

  18. Beiser A, D'Agostino RB Sr, Seshadri S, Sullivan LM, Wolf PA (2000) Computing estimates of incidence, including lifetime risk: Alzheimer's disease in the Framingham Study. The Practical Incidence Estimators (PIE) macro. Stat Med 19:1495–1522

    Article  CAS  PubMed  Google Scholar 

  19. Gooley TA, Leisenring W, Crowley J, Storer BE (1999) Estimation of failure probabilities in the presence of competing risks: new representations of old estimators. Stat Med 18:695–706

    Article  CAS  PubMed  Google Scholar 

  20. Iceland S (2008) Population. Statistical series (Hagtídindi). Reykjavik, Iceland

  21. Ettinger B, Black DM, Dawson-Hughes B, Pressman AR, Melton LJ 3rd (2010) Updated fracture incidence rates for the US version of FRAX. Osteoporos Int 21:25–33

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Gronskag AB, Forsmo S, Romundstad P, Langhammer A, Schei B (2010) Incidence and seasonal variation in hip fracture incidence among elderly women in Norway. The HUNT Study. Bone 46:1294–1298

    Article  PubMed  Google Scholar 

  23. Singer BR, McLauchlan GJ, Robinson CM, Christie (1998) Epidemiology of fractures in 15,000 adults: the influence of age and gender. J Bone Joint Surg Br 80:243–248

    Article  CAS  PubMed  Google Scholar 

  24. Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM et al (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22:1277–1288

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  25. Lofthus CM, Osnes EK, Falch JA, Kaastad TS, Kristiansen IS, Nordsletten L et al (2001) Epidemiology of hip fractures in Oslo, Norway. Bone 29:413–418

    Article  CAS  PubMed  Google Scholar 

  26. Jonsson B, Gärdsell P, Johnell O, Redlund-Johnell I, Sernbo I (1992) Differences in fracture pattern between an urban and a rural population: a comparative population-based study in southern Sweden. Osteoporos Int 2:269–273

    Article  CAS  PubMed  Google Scholar 

  27. Bjorgul K, Reikeras O (2007) Incidence of hip fracture in southeastern Norway: a study of 1,730 cervical and trochanteric fractures. Int Orthop 31:665–669

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Lofman O, Berglund K, Larsson L, Toss G (2002) Changes in hip fracture epidemiology: redistribution between ages, genders and fracture types. Osteoporos Int 13:18–25

    Article  CAS  PubMed  Google Scholar 

  29. Olafsdottir E, Aspelund T, Torfadottir JE, Steingrimsdottir L, Sigurdsson G, Thorsson B et al (2012) Early life residency associated with the risk of developing type 2 diabetes—the population-based Reykjavik Study. Laeknabladid 98:639–644

    PubMed  Google Scholar 

  30. Joakimsen RM, Fonnebo V, Sogaard AJ, Tollan A, Stormer J, Magnus JH (2001) The Tromso study: registration of fractures, how good are self-reports, a computerized radiographic register and a discharge register? Osteoporos Int 12:1001–1005

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We are grateful to Olafur Grimur Bjornsson, M.D., Ph.D., and David Vilmundarson for helpful comments on the manuscript and to the staff of the Icelandic Heart Association Research Institute for their contribution.

Funding

This study was funded by Hjartavernd (The Icelandic Heart Association) and Althingi (The Icelandic Parliament).

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Icelandic Heart Association Research Institute, Holtasmari 1, IS-201, Kopavogur, Iceland

    K. Siggeirsdottir, T. Aspelund, E. F. Gudmundsson & V. Gudnason

  2. University of Iceland, Reykjavik, Iceland

    T. Aspelund, B. Mogensen, V. Gudnason & G. Sigurdsson

  3. Department of Orthopeadics, Skane University Hospital, Malmö, Sweden

    B. Y. Jonsson

  4. Landspitalinn University Hospital, Reykjavik, Iceland

    B. Mogensen & G. Sigurdsson

Authors
  1. K. Siggeirsdottir
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  2. T. Aspelund
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  3. B. Y. Jonsson
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  4. B. Mogensen
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  5. E. F. Gudmundsson
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  6. V. Gudnason
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  7. G. Sigurdsson
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Corresponding author

Correspondence to K. Siggeirsdottir.

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Siggeirsdottir, K., Aspelund, T., Jonsson, B.Y. et al. Epidemiology of fractures in Iceland and secular trends in major osteoporotic fractures 1989–2008. Osteoporos Int 25, 211–219 (2014). https://doi.org/10.1007/s00198-013-2422-6

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  • DOI: https://doi.org/10.1007/s00198-013-2422-6

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