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Secular decreases in fracture rates 1986–2006 for Manitoba, Canada: a population-based analysis

Osteoporosis International volume 22, pages 2137–2143 (2011)Cite this article

Abstract

Summary

We examined trends in fracture rates over 20 years in the Province of Manitoba, Canada. Hip fractures, major low-trauma fractures, and high-trauma fractures declined significantly from 1986 to 2006.

Introduction

Secular decreases in hip fracture rates have been reported in some countries. Whether this phenomenon applies to other fracture sites is not well described.

Methods

We used 20 years of data from the Population Health Research Data Repository for the Province of Manitoba, Canada. Age-adjusted fracture rates were calculated for men and women age 50 years and older 1986–2006 according to fracture site and mechanism (presence/absence of external injury codes). Generalized linear models with generalized estimating equations were used to derive adjusted annual rates and test for linear change in men and women.

Results

Major low-trauma fractures (hip, forearm, spine, and humerus) showed a significant annual linear decline in women (−1.2% [95% CI, −0.7% to −1.8%]) and in men (−0.4% [95% CI, −0.7% to −0.2%]). Hip fracture showed a significant annual decline for both sexes, while forearm and humerus fractures showed a significant decline only in women. The only fracture category that did not show a significant annual decline in either sex was the spine. The observed annual reduction in high-trauma fractures was even larger and did not show a sex difference (−1.8% [95% CI, −2.8% to −0.7%]).

Conclusion

We observed a decrease in both low-trauma and high-trauma fracture rates over the study period. This decline was apparent in years prior to widespread osteoporosis testing or availability of modern pharmacotherapy.

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Acknowledgments

We are indebted to Manitoba Health for providing access to the data (HIPC File No. 2008/2009-16). The results and conclusions are those of the authors, and no official endorsement by Manitoba Health is intended or should be inferred.

Sources of support

This study was funded through a research grant from Amgen Canada Ltd. The funding source had no access to the data prior to publication, no input into the writing of the manuscript, and no input in the decision to publish the results.

Conflicts of interest

William Leslie is part of a speaker bureau and has received unrestricted research grants from Merck Frosst, has received research honoraria and unrestricted educational grants from Sanofi-Aventis and Procter & Gamble, has received unrestricted research grants from Novartis and Amgen, has received unrestricted educational grants from Genzyme, and is a member of the following advisory boards: Genzyme, Novartis, and Amgen.

Mohsen Sadatsafavi has nothing to declare.

Lisa Lix has received unrestricted research grant from Amgen.

Mahmoud Azimaee has nothing to declare.

Suzanne Morin has acted as a consultant to Procter & Gamble, Sanofi-Aventis, Servier, Amgen, and Novartis; is part of a speaker bureau for Procter& Gamble and Sanofi-Aventis; and has received unrestricted research grant from Amgen.

Colleen Metge has received unrestricted research grant from Amgen.

Patricia Caetano has received unrestricted research grant from Amgen.

Author information

Affiliations

  1. University of Manitoba, Winnipeg, Canada

    W. D. Leslie, M. Azimaee, C. J. Metge & P. Caetano

  2. University of British Columbia, Vancouver, BC, Canada

    M. Sadatsafavi

  3. University of Saskatchewan, Saskatoon, SK, Canada

    L. M. Lix

  4. McGill University, Montreal, QC, Canada

    S. Morin

  5. Department of Medicine (C5121), University of Manitoba, 409 Tache Avenue, Winnipeg, Canada, R2H 2A6

    W. D. Leslie

Authors
  1. W. D. Leslie
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  2. M. Sadatsafavi
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  3. L. M. Lix
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  4. M. Azimaee
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  5. S. Morin
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  6. C. J. Metge
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  7. P. Caetano
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Corresponding author

Correspondence to W. D. Leslie.

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Leslie, W.D., Sadatsafavi, M., Lix, L.M. et al. Secular decreases in fracture rates 1986–2006 for Manitoba, Canada: a population-based analysis. Osteoporos Int 22, 2137–2143 (2011). https://doi.org/10.1007/s00198-010-1470-4

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  • DOI: https://doi.org/10.1007/s00198-010-1470-4

Keywords

  • Administrative data
  • Epidemiology
  • Fracture
  • Historical cohort study
  • Osteoporosis