The National Hospital Discharge Survey was used to analyze secular tre
nds from 1965 to 1993 in hip fracture incidence and in-hospital surviv
al in the White US. population 50 years of age and older. Age-specific
fracture rates increased significantly for males in age groups 80-84
years and 85 years and older but not for younger males. For females, a
ge-specific rates did not change significantly over the time period. A
ge-specific survival rates increased for both older males and females,
but the increase was greatest for the older men. Why hip fracture inc
idence is increasing in older males but not in females and younger mal
es is not clear. But the high lifetime prevalence of smoking in the ol
der cohort of males may be a factor. With rising incidence rates in el
derly males, prevention efforts, which have focused primarily on women
because of their high fracture rates, should target both sexes.