Age at hip fracture and life expectancy in Denmark: Secular trends over two decades

Bo Abrahamsen*, Henrik V.B. Laursen, Michael K. Skjødt, Morten H. Jensen, Peter Vestergaard

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Background: Recent improvements in the health of the oldest old coexist with a decline in hip fracture rates, in particular in women. We speculated that increased longevity with decreasing hip fracture rates would result in a delay in hip fracture. We conducted an analysis of time trends in the age at hip fracture, by type and gender, for the past two decades using national data. Study population and methods: We used data from the Danish Hospital Discharge Register (1996–2017) to analyse the age distribution of femoral neck (FN) and pertrochanteric fractures (PT), allowing only the first fracture at each of these two sites to contribute to the analysis in each calendar year. Demographics for the background population at risk including life expectancy tabulations, were also obtained. Results: The average age at FN fracture in women increased slowly but significantly by 0.035 years - or 12.8 days - per calendar year [0.035, 95% CI (0.016; 0.054), p < 0.001], resulting in an increase from 79.6 to 80.4 years. There were no significant changes in the age at FN fracture in men or the age at PT fracture in women and men. Further, increases in life expectancy were considerably faster than any change observed in the age at hip fracture. In 1996, the average age at FN or PT fracture exceeded the average life expectancy in both men and women whereas the opposite was the case from 2009 and onwards in men and 2015 and onwards in women. Conclusion: This study demonstrates a significant change in the demographics of hip fractures in Denmark over the past two decades. We observed a significant increase in the age at FN fracture in women but not in men, with no significant increase in the age at IT fracture and PT fracture. This developed much more slowly, however, than the increase in life expectancy in both sexes observed over the same period of time. Taken together, these changes resulted in a large decrease in the female to male incidence rate ratio from 2.6 and 2.5 (FN and PT, respectively) to 1.9 and 1.7.Additional effort is required to prevent hip fractures to ensure that the increasing life expectancy is matched by a similar increase in hip-fracture free life expectancy.

OriginalsprogEngelsk
Artikelnummer115083
Tidsskriftbone
Vol/bind130
Antal sider6
ISSN8756-3282
DOI
StatusUdgivet - jan. 2020

Fingeraftryk

Denmark
Life Expectancy
Femoral Neck Fractures
Femur Neck
Age Distribution
Incidence
Health
Population

Citer dette

Abrahamsen, Bo ; Laursen, Henrik V.B. ; Skjødt, Michael K. ; Jensen, Morten H. ; Vestergaard, Peter. / Age at hip fracture and life expectancy in Denmark : Secular trends over two decades. I: bone. 2020 ; Bind 130.
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title = "Age at hip fracture and life expectancy in Denmark: Secular trends over two decades",
abstract = "Background: Recent improvements in the health of the oldest old coexist with a decline in hip fracture rates, in particular in women. We speculated that increased longevity with decreasing hip fracture rates would result in a delay in hip fracture. We conducted an analysis of time trends in the age at hip fracture, by type and gender, for the past two decades using national data. Study population and methods: We used data from the Danish Hospital Discharge Register (1996–2017) to analyse the age distribution of femoral neck (FN) and pertrochanteric fractures (PT), allowing only the first fracture at each of these two sites to contribute to the analysis in each calendar year. Demographics for the background population at risk including life expectancy tabulations, were also obtained. Results: The average age at FN fracture in women increased slowly but significantly by 0.035 years - or 12.8 days - per calendar year [0.035, 95{\%} CI (0.016; 0.054), p < 0.001], resulting in an increase from 79.6 to 80.4 years. There were no significant changes in the age at FN fracture in men or the age at PT fracture in women and men. Further, increases in life expectancy were considerably faster than any change observed in the age at hip fracture. In 1996, the average age at FN or PT fracture exceeded the average life expectancy in both men and women whereas the opposite was the case from 2009 and onwards in men and 2015 and onwards in women. Conclusion: This study demonstrates a significant change in the demographics of hip fractures in Denmark over the past two decades. We observed a significant increase in the age at FN fracture in women but not in men, with no significant increase in the age at IT fracture and PT fracture. This developed much more slowly, however, than the increase in life expectancy in both sexes observed over the same period of time. Taken together, these changes resulted in a large decrease in the female to male incidence rate ratio from 2.6 and 2.5 (FN and PT, respectively) to 1.9 and 1.7.Additional effort is required to prevent hip fractures to ensure that the increasing life expectancy is matched by a similar increase in hip-fracture free life expectancy.",
keywords = "Epidemiology, Hip fracture, Life expectancy, Osteoporosis, Prevention",
author = "Bo Abrahamsen and Laursen, {Henrik V.B.} and Skj{\o}dt, {Michael K.} and Jensen, {Morten H.} and Peter Vestergaard",
year = "2020",
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doi = "10.1016/j.bone.2019.115083",
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Age at hip fracture and life expectancy in Denmark : Secular trends over two decades. / Abrahamsen, Bo; Laursen, Henrik V.B.; Skjødt, Michael K.; Jensen, Morten H.; Vestergaard, Peter.

I: bone, Bind 130, 115083, 01.2020.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Age at hip fracture and life expectancy in Denmark

T2 - Secular trends over two decades

AU - Abrahamsen, Bo

AU - Laursen, Henrik V.B.

AU - Skjødt, Michael K.

AU - Jensen, Morten H.

AU - Vestergaard, Peter

PY - 2020/1

Y1 - 2020/1

N2 - Background: Recent improvements in the health of the oldest old coexist with a decline in hip fracture rates, in particular in women. We speculated that increased longevity with decreasing hip fracture rates would result in a delay in hip fracture. We conducted an analysis of time trends in the age at hip fracture, by type and gender, for the past two decades using national data. Study population and methods: We used data from the Danish Hospital Discharge Register (1996–2017) to analyse the age distribution of femoral neck (FN) and pertrochanteric fractures (PT), allowing only the first fracture at each of these two sites to contribute to the analysis in each calendar year. Demographics for the background population at risk including life expectancy tabulations, were also obtained. Results: The average age at FN fracture in women increased slowly but significantly by 0.035 years - or 12.8 days - per calendar year [0.035, 95% CI (0.016; 0.054), p < 0.001], resulting in an increase from 79.6 to 80.4 years. There were no significant changes in the age at FN fracture in men or the age at PT fracture in women and men. Further, increases in life expectancy were considerably faster than any change observed in the age at hip fracture. In 1996, the average age at FN or PT fracture exceeded the average life expectancy in both men and women whereas the opposite was the case from 2009 and onwards in men and 2015 and onwards in women. Conclusion: This study demonstrates a significant change in the demographics of hip fractures in Denmark over the past two decades. We observed a significant increase in the age at FN fracture in women but not in men, with no significant increase in the age at IT fracture and PT fracture. This developed much more slowly, however, than the increase in life expectancy in both sexes observed over the same period of time. Taken together, these changes resulted in a large decrease in the female to male incidence rate ratio from 2.6 and 2.5 (FN and PT, respectively) to 1.9 and 1.7.Additional effort is required to prevent hip fractures to ensure that the increasing life expectancy is matched by a similar increase in hip-fracture free life expectancy.

AB - Background: Recent improvements in the health of the oldest old coexist with a decline in hip fracture rates, in particular in women. We speculated that increased longevity with decreasing hip fracture rates would result in a delay in hip fracture. We conducted an analysis of time trends in the age at hip fracture, by type and gender, for the past two decades using national data. Study population and methods: We used data from the Danish Hospital Discharge Register (1996–2017) to analyse the age distribution of femoral neck (FN) and pertrochanteric fractures (PT), allowing only the first fracture at each of these two sites to contribute to the analysis in each calendar year. Demographics for the background population at risk including life expectancy tabulations, were also obtained. Results: The average age at FN fracture in women increased slowly but significantly by 0.035 years - or 12.8 days - per calendar year [0.035, 95% CI (0.016; 0.054), p < 0.001], resulting in an increase from 79.6 to 80.4 years. There were no significant changes in the age at FN fracture in men or the age at PT fracture in women and men. Further, increases in life expectancy were considerably faster than any change observed in the age at hip fracture. In 1996, the average age at FN or PT fracture exceeded the average life expectancy in both men and women whereas the opposite was the case from 2009 and onwards in men and 2015 and onwards in women. Conclusion: This study demonstrates a significant change in the demographics of hip fractures in Denmark over the past two decades. We observed a significant increase in the age at FN fracture in women but not in men, with no significant increase in the age at IT fracture and PT fracture. This developed much more slowly, however, than the increase in life expectancy in both sexes observed over the same period of time. Taken together, these changes resulted in a large decrease in the female to male incidence rate ratio from 2.6 and 2.5 (FN and PT, respectively) to 1.9 and 1.7.Additional effort is required to prevent hip fractures to ensure that the increasing life expectancy is matched by a similar increase in hip-fracture free life expectancy.

KW - Epidemiology

KW - Hip fracture

KW - Life expectancy

KW - Osteoporosis

KW - Prevention

U2 - 10.1016/j.bone.2019.115083

DO - 10.1016/j.bone.2019.115083

M3 - Journal article

C2 - 31622776

AN - SCOPUS:85073696452

VL - 130

JO - Bone

JF - Bone

SN - 8756-3282

M1 - 115083

ER -