According to a recent study done by scientists at the University of Hong Kong, osteoporotic hip fracture, which is already a dangerous and devastating condition for senior men and women throughout the world, is set to deteriorate as the population ages and gets more frail. According to the study, men and adults over the age of 85 are especially vulnerable to osteoporosis and fractures, highlighting the need for more research, prevention, and treatment.
Associate Professor Ching-lung Cheung of the University of Hong Kong’s Department of Pharmacology and Pharmacy presented the findings today at the annual conference of the American Society of Bone and Mineral Research in Austin, Texas.
The study examined data from 19 countries for individuals aged 50 and over who sustained hip fractures between 2005 and 2018. It was revealed that an overall increase in the number of hip fractures was predicted in 18 of the 19 nations studied. Hip fracture rates were forecasted for 2030 and 2050 using World Bank population estimates.
Hip fracture rates are expected to more than double globally by 2050, with males having a greater proportionate rise than women.
The study identified many probable explanations of the gender discrepancy. Although the frequency of hip fractures dropped in the majority of countries throughout the study period, the amount of the reduction was lower in men. Men are living longer lives as a result of advancements in healthcare, personal cleanliness, food, and other areas. According to the United Nations, the average life expectancy for males would be over 75 years by 2050, which coincides to the age range where this study discovered a significant risk of hip fracture.
As a result, researchers estimate an increase in the number of men who are at high risk of hip fracture.
Similarly, osteoporosis in males has long gone undetected and untreated, according to Dr. Cheung. Our research also found that males are 30% to 67% less likely than women to take anti-osteoporosis medications following a hip fracture, he said. As a result, more emphasis should be made on the prevention and treatment of men’s hip fractures.
Previous research on the occurrence of hip fractures relied on dated data from various study approaches and historical periods. This study looked at the most recent secular trends in hip fracture incidence, mortality, and post-fracture pharmacological therapy in 19 different countries.
To deliver comparable data across all sites, a standard protocol and data model were used. The annual incidence of hip fracture, death, and rates of pharmacological therapy within a year were computed using age- and sex-standardized data.
The researchers discovered significant variation among the 19 countries they looked at using descriptive analyses of patient-level healthcare data.
Hip fracture incidence was calculated to be 180 per 100,000 people overall, controlling for age and sex (Women 236; Men 118). However, the average annual change in the incidence of hip fractures ranged from -2.8% to +2.1%. The countries with the largest reductions in fractures were Hong Kong (2.4%), Singapore (2.8%), and Denmark (2.8%).
The Netherlands (+2.1%) and South Korea (+1.2%) saw the largest gains. One-year all-cause mortality ranged from 14.4% to 28.3%, while mortality trends ranged from 5.3% to +18.4% annually, with Australia (5.3%), the Netherlands (4.6%), and Singapore (4.3%) recording the highest declines. 11.5% to 50.3% of hip fracture patients took an anti-osteoporosis drug within a year of the fracture, with yearly trends ranging from 9.6% to +12.7% and dropping in 6 of 15 locations.
Further in-depth investigation is needed to determine the causes of the observed variation among nations, according to co-author and research assistant professor Chor Wing Sing. Better osteoporosis therapy and post-fracture care, according to the expert, may be the cause of some countries’ relatively large hip fracture decreases. Better fall-prevention initiatives and more precise clinical care standards undoubtedly contributed to the improvement.
A rise in bone mineral density, or BMD, as a result of people’s increased awareness of bone health, according to Dr. Sing, may also have been helpful. She referenced a study from Hong Kong, where there had been one of the highest decreases in hip fractures, which shown that women over 50 had started getting more active and undertaking more weight-bearing activity, which had led to a considerable long-term increase in BMD.
Impact of ageing on hip fractures
The main takeaway from the new study, according to its authors, is that the impact of the ageing population cannot be completely offset by the decrease in hip fractures that has occurred in many nations in recent years. Hip fractures are anticipated to become more common. However, post-fracture care is still insufficient in many nations.
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While post-fracture care in this demographic is typically conservative, the incidence of hip fracture in those over 85 (the “oldest old”) continues to be more than double that of other age groups.
A stronger and more coordinated effort by healthcare professionals, patients, and caregivers will be necessary to prevent hip fractures, bridge the treatment gap, and improve post-fracture care, particularly in males and the elderly. There is an urgent need for this all around the world.
