Secular trends in the incidence of hip and other osteoporotic fractures

  • C. CooperEmail author
  • Z. A. Cole
  • C. R. Holroyd
  • S. C. Earl
  • N. C. Harvey
  • E. M. Dennison
  • L. J. Melton
  • S. R. Cummings
  • J. A. Kanis
  • The IOF CSA Working Group on Fracture Epidemiology


Osteoporosis constitutes a major public health problem through its association with age-related fractures, most notably those of the proximal femur. Substantial geographic variation has been noted in the incidence of hip fracture throughout the world, and estimates of recent incidence trends have varied widely. Studies in the published literature have reported an increase, plateau, and decrease in age-adjusted incidence rates for hip fracture among both men and women. Accurate characterisation of these temporal trends is important in predicting the health care burden attributable to hip fracture in future decades. We therefore conducted a review of studies worldwide, addressing secular trends in the incidence of hip and other fractures. Studies in western populations, whether in North America, Europe or Oceania, have generally reported increases in hip fracture incidence through the second half of the last century, but those continuing to follow trends over the last two decades have found that rates stabilise with age-adjusted decreases being observed in certain centres. In contrast, some studies suggest that the rate is rising in Asia. This synthesis of temporal trends in the published literature will provide an important resource for preventing fractures. Understanding the reasons for the recent declines in rates of hip fracture may help understand ways to reduce rates of hip fracture worldwide.


Epidemiology Hip fracture Incidence Osteoporosis Temporal trend 



This study was supported by the Medical Research Council, International Osteoporosis Foundation and NIHR Musculoskeletal Biomedical Research Unit, Oxford. The manuscript was prepared by Vivienne Cresdee and Gill Strange. It is endorsed by the Committee of Scientific Advisors of the IOF.

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • C. Cooper
    • 1
    • 2
    Email author
  • Z. A. Cole
    • 1
  • C. R. Holroyd
    • 1
  • S. C. Earl
    • 1
  • N. C. Harvey
    • 1
  • E. M. Dennison
    • 1
  • L. J. Melton
    • 3
  • S. R. Cummings
    • 4
  • J. A. Kanis
    • 5
  • The IOF CSA Working Group on Fracture Epidemiology
  1. 1.The MRC Lifecourse Epidemiology Unit, Southampton General HospitalUniversity of SouthamptonSouthamptonUK
  2. 2.NIHR Musculoskeletal Biomedical Research Unit, Institute of Musculoskeletal SciencesUniversity of OxfordOxfordUK
  3. 3.Section of Clinical Epidemiology, Department of Health Sciences ResearchMayo ClinicRochesterUSA
  4. 4.SF Co-ordinating CenterSan FranciscoUSA
  5. 5.Centre for Metabolic Bone Diseases (WHO Collaborating Centre)University of Sheffield Medical SchoolSheffieldUK

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