Epidemiology of fractures in Iceland and secular trends in major osteoporotic fractures 1989–2008
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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.
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.
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.
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.
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.
KeywordsEpidemiology Fracture incidence Major osteoporotic fractures Secular changes The Reykjavik Study
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.
This study was funded by Hjartavernd (The Icelandic Heart Association) and Althingi (The Icelandic Parliament).
Conflicts of interest
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