Hip fractures in the elderly: A world-wide projection


Hip fractures are recognized to be a major public health problem in many Western nations, most notably those in North America, Europe and Oceania. Incidence rates for hip fracture in other parts of the world are generally lower than those reported for these predominantly Caucasian populations, and this has led to the belief that osteoporosis represents less of a problem to the nations of Asia, South American and Africa. Demographic changes in the next 60 years, however, will lead to huge increases in the elderly populations of those countries. We have applied available incidence rates for hip fracture from various parts of the world to projected populations in 1990, 2025 and 2050 in order to estimate the numbers of hip fractures which might occur in each of the major continental regions. The projections indicate that the number of hip fractures occurring in the world each year will rise from 1.66 million in 1990 to 6.26 million by 2050. While Europe and North America account for about half of all hip fractures among elderly people today, this proportion will fall to around one quarter in 2050, by which time steep increases will be observed throughout Asia and Latin America. The results suggest that osteoporosis will truly become a global problem over the next half century, and that preventive strategies will be required in parts of the world where they are not currently felt to be necessary.

This is a preview of subscription content, log in to check access.


  1. 1.

    Cummings SR, Black DM, Rubin SM. Lifetime risks of hip, Colles', or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med 1989;149:2445–8.

    Google Scholar 

  2. 2.

    Chrischilles EA, Butler CD, Davis CS, Wallace RB. A model of lifetime osteoporosis impact. Arch Intern Med 1991;151:2026–32.

    Google Scholar 

  3. 3.

    Anon. Osteoporosis. In: Berg RL, Cassells JS, editors. The second fifty years: promoting health and preventing disability. Washington DC, National Academy Press, 1990:76–100.

  4. 4.

    Melton LJ, III. Epidemiology of fractures. In: Riggs BL, Melton LJ III, editors. Osteoporosis: etiology, diagnosis and management. Raven Press, New York, 1988:133–54.

    Google Scholar 

  5. 5.

    Maggi S, Kelsey JL, Litvak J, Heyse SP. Incidence of hip fractures in the elderly: a cross-national analysis. Osteoporosis Int 1991;1:232–41.

    Google Scholar 

  6. 6.

    Solomon L. Osteoporosis and fracture of the femoral neck in the South African Bantu. J Bone Joint Surg [Br] 1968;50B:2–13.

    Google Scholar 

  7. 7.

    Bagur A, Rubin Z, Garcia M, Mautalen C. Epidemiology of osteoporosis in Argentina. In: Christiansen C, Overgaard K, editors. Osteoporosis 1990. Proceedings of the Third International Symposium on Osteoporosis, Copenhagen, Denmark, Vol. 1. Copenhagen, Denmark: Osteopress ApS, 1990:86–8.

    Google Scholar 

  8. 8.

    Lau EMC, Cooper C, Wickham C, Donnan S, Barker DJP. Hip fracture in Hong Kong and Britain. Int J Epidemiol 1990;19:1119–21.

    Google Scholar 

  9. 9.

    Melton LJ, III, O'Fallon WM, Riggs BL. Secular trends in the incidence of hip fractures. Calcif Tissue Int 1987;41:57–64.

    Google Scholar 

  10. 10.

    Boyce WJ, Vessey MP. Rising incidence of fracture of the proximal femur. Lancet 1985;1:150–1.

    Google Scholar 

  11. 11.

    Stott S, Gray DH, Stevenson W. The incidence of femoral neck fracture in New Zealand. NZ Med J 1980;91:6–9.

    Google Scholar 

  12. 12.

    Pogrund H, Makin M, Robin G, Menczel J, Steinberg R. The epidemiology of femoral neck fractures in Jerusalem. Clin Orthop 1977;122:141–6.

    Google Scholar 

  13. 13.

    Wong PCN. Fracture epidemiology in a mixed Southeastern Asian community (Singapore). Clin Orthop 1966;45:55–61.

    Google Scholar 

  14. 14.

    Chalmers J, Ho KC. Geographical variations in senile osteoporosis: the association with physical activity. J Bone Joint Surg [Br] 1979;52B:667–75.

    Google Scholar 

  15. 15.

    Bauer RL. Ethnic differences in hip fracture: a reduced incidence in Mexican Americans. Am J Epidemiol 1988;127:145–9.

    Google Scholar 

  16. 16.

    Farmer ME, White LR, Brody JA, Bailey KR. Race and sex differences in hip fracture incidence. Am J Public Health 1984;74:1374–80.

    Google Scholar 

  17. 17.

    Melton LJ. Hip fracture incidence rates. Am J Public Health 1990;80:500.

    Google Scholar 

  18. 18.

    Falch JA, Ilbekk A, Slungaard U. Epidemiology of hip fractures in Norway. Acta Orthop Scand 1985;56:12–6.

    Google Scholar 

  19. 19.

    Finsen V, Benum P. Changing incidence of hip fractures in rural and urban areas of central Norway. Clin Orthop 1987;218:104–10.

    Google Scholar 

  20. 20.

    Hedlund R, Lindgren U, Ahlbom A. Age- and sex-specific incidence of femoral neck and trochanteric fractures: an analysis based on 20 538 fractures in Stockholm County, Sweden, 1971–1981. Clin Orthop 1987;222:132–9.

    Google Scholar 

  21. 21.

    Frandsen PA, Kruse T. Hip fractures in the county of Funen, Denmark: implications of demographic aging and changes in incidence rates. Acta Orthop Scand 1983;54:681–6.

    Google Scholar 

  22. 22.

    Lizaur-Utrilla A, Puchades Orts A, Sanches del Campo F, Anta Bario J, Gutierrez Carbonell P. Epidemiology of trochanteric fractures of the femur in Alicante, Spain, 1974–1982. Clin Orthop 1987;218:24–31.

    Google Scholar 

  23. 23.

    Caniggia M, Morreale P. Epidemiology of hip fractures in Siena, Italy, 1975–1985. Clin Orthop 1989;238:131–8.

    Google Scholar 

  24. 24.

    Melton LJ III. Differing patterns of osteoporosis across the world. In: Chesnut CH, editor. New dimension in osteoporosis in the 1990s. Hong Kong: Excerpta Medica Asia, 1991:13–8.

    Google Scholar 

  25. 25.

    Hedlund R, Ahlbom A, Lindgren U. Hip fracture incidence in Stockholm 1972–1981. Acta Orthop Scand 1985;57:30–4.

    Google Scholar 

  26. 26.

    Spector TD, Cooper C, Lewis AF. Trends in admissions for hip fracture in England and Wales, 1968–85. Br Med J 1990;300:1173–4.

    Google Scholar 

  27. 27.

    Lau EMC, Cooper C, Donnan S, Barker DJP. Incidence and risk factors for hip fractures in Hong Kong Chinese. In: Christiansen C, Overgaard K, editors. Osteoporosis 1990. Proceedings of the Third International Symposium on Osteoporosis, vol. 1, Copenhagen, Denmark: Osteopress ApS, 1990:66–70.

    Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Dr L. J. Melton III.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Cooper, C., Campion, G. & Melton, L.J. Hip fractures in the elderly: A world-wide projection. Osteoporosis Int 2, 285–289 (1992). https://doi.org/10.1007/BF01623184

Download citation


  • Epidemiology
  • Hip fracture
  • Incidence
  • Osteoporosis