Summary
Several studies suggest secular increases in hip fracture incidence through this century, but little is known about such trends for vertebral fracture. We have examined changes in the incidence of clinically ascertained vertebral fractures among Rochester, Minnesota residents aged 35–69 years, that were first diagnosed between 1950 and 1989. Our results indicate no overall increase in incidence over the 40-year period. Categorization of fractures according to the level of preceding trauma, however, revealed a significant increase in the incidence of fractures following moderate trauma among women aged 60–69 years. This increase occurred between 1950 and 1964, and leveled off thereafter. Rates for severe trauma fractures among postmenopausal women, and for vertebral fractures from any cause among younger men and women, remained stable. The rise in moderate trauma fractures in postmenopausal women paralleled that for hip fractures in Rochester and began to plateau at around the same time. It might have resulted from increased diagnosis of vertebral fractures, but the increase in hip fracture incidence is inconsistent with this explanation. An increase in the prevalence of osteoporosis, however, might account for the trend in both types of fractures.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Melton LJ III (1990) Osteoporosis. In: Berg RL, Cassells JS (eds) The second fifty years. Promoting health and preventing disability. National Academy Press, Washington, DC, p 76
Grazier KL, Holbrook TL, Kelsey J, Stauffer RN (1984) The frequency of occurrence, impact and cost of musculoskeletal conditions in the United States. American Academy of Orthopaedic Surgeons, Chicago
Melton LJ III, O'Fallon WM, Riggs BL (1987) Secular trends in the incidence of hip fractures. Calcif Tissue Int 41:57–64
Melton LJ III (1990) Epidemiology of fractures in North America. In: Christiansen C, Overgaard K (eds) Osteoporosis 1990. Proc 3rd Intl Symp on Osteoporosis. Osteopress ApS, Copenhagen, vol. 1, p 36
Bengnér U, Johnell O, Redlund-Johnell I (1988) Changes in incidence and prevalence of vertebral fractures during 30 years. Calcif Tissue Int 42:293–296
Hansen MA, Overgaard K, Gotfredson A, Christiansen C (1990) Does the prevalence of vertebral fractures increase? In: Christiansen C, Overgaard K (eds) Osteoporosis 1990. Osteopress ApS, Copenhagen, p 95
Kurland LT, Molgaard CA (1981) The patient record in epidemiology. Sci Am 245:54–63
Schroeder DJ, Offord KP (1982) A SAS macro which utilizes local and reference population counts appropriate for incidence, prevalence, and mortality rate calculations in Rochester and Olmsted County, Minnesota. Technical Report Series, No. 20, Section of Medical Research Statistics, Mayo Clinic, Rochester, Minnesota
Bergstralh EJ, Offord KP (1988) Projected Rochester and Olmsted County populations for 1981–1995. Technical Report Series, No. 38, Section of Medical Research Statistics, Mayo Clinic, Rochester, Minnesota
Melton LJ III, Kan SH, Frye MA, Wahner HW, O'Fallon WM, Riggs BL (1989) Epidemiology of vertebral fractures in women. Am J Epidemiol 129:1000–1011
Cooper C, Atkinson EJ, O'Fallon WM, Melton LJ (1992) Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 7:221–227
Krølner B, Pors-Nielsen S (1982) Bone mineral content of the lumbar spine in normal and osteoporotic women: crosssectional and longitudinal studies. Clin Sci 62:329–336
Firooznia H, Golimbu C, Rafii M, Schwartz MS, Alterman ER (1984) Quantitative computed tomography assessment of spinal trabecular bone. II. Osteoporotic women with and without vertebral fractures. CT: J Comput Tomogr 8:99–103
Cann CE, Genant HK, Kolb FO, Ettinger B (1985) Quantitative computed tomography for prediction of vertebral fracture risk. Bone 6:1–7
Hayes WC, Piazza SJ, Zysset PK (1991) Biomechanics of fracture risk prediction of the hip and spine by quantitative computed tomography. Radiol Clin North Am 29:1–18
Spector TD, Cooper C, Lewis AF (1990) Trends in admissions for hip fracture incidence in England and Wales, 1968–85. Br Med J 300:1173–1174
Melton LJ III, Bergstralh EJ, Malkasian GD, O'Fallon WM (1991) Bilateral oophorectomy trends in Olmsted County, Minnesota, 1950–1987. Epidemiology 2:149–152
Rosenberg L, Shapiro S, Kaufman DW, Slone S, Miettinen OS, Stolley PD (1979) Patterns and determinants of conjugated estrogen use. Am J Epidemiol 109:676–686
Hemminki E, Kennedy DL, Baum C, McKinlay SM (1988) Prescribing of non-contraceptive estrogens and progestins in the United States, 1974–86. Am J Publ Hlth 78:1479–1481
Cooper C, Wickham C (1990) Cigarette smoking and the risk of age-related fractures. In: Wald N, Froggatt P (eds) Smoking and hormone-related disorders. Oxford University Press, Oxford, p 93
Spencer H, Rubio N, Rubio E, Indreika M, Seitam A (1986) Chronic alcoholism: frequently overlooked cause of osteoporosis in man. Am J Med 80:393–397
Seeman E, Melton LJ III, O'Fallon WM, Riggs BL (1983) Risk factors for spinal osteoporosis in men. Am J Med 75:977–983
Schaafsma G, van Beresteyn ECH, Raymakers JA, Duursma SA (1987) Nutritional aspects of osteoporosis. World Rev Nutr Diet 49:121–159
Cooper C, Barker DJP, Wickman C (1988) Physical activity, muscle strength and calcium intake in fracture of the proximal femur in Britain. Br Med J 279:1443–1446
Lau E, Donnan S, Barker DJP, Cooper C (1988) Physical activity and calcium intake in fracture of the proximal femur in Hong Kong. Br Med J 297:1441–1443
Zain Elabdien BSZ, Olerud S, Karlström G, Smedby B (1984) Rising incidence of hip fracture in Uppsala, 1965–1980. Acta Orthop Scand 55:284–289
Lau EMC, Cooper C, Wickham C, Donnan S, Barker DJP (1990) Hip fracture in Hong Kong and Britain. Int J Epidemiol 19:1119–1121
Jacobs DR, Hahn LP, Folsom AR, Hannan PJ, Sprafka JM, Burke GL (1991) Time-trends in leisure-time physical activity in the Upper Midwest 1957–1987: University of Minnesota studies. Epidemiology 2:8–15
Riggs BL, Melton LJ III (1986) Involutional osteoporosis. N Engl J Med 314:1676–1686
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cooper, C., Atkinson, E.J., Kotowicz, M. et al. Secular trends in the incidence of postmenopausal vertebral fractures. Calcif Tissue Int 51, 100–104 (1992). https://doi.org/10.1007/BF00298496
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00298496