Age- and gender-specific rate of fractures in Australia: A population based study

There is little population-based data concerning fracture rates in Australi a. We ascertained all fractures occurring during 2 years in adults aged 35 years and over residing within a defined region (population 218 000), repre sentative of the Australian population. The major strength of this study is the comprehensive ascertainment of fractures, which was ensured by regular searches of the only two radiologic providers in the Geelong Osteoporosis Study region. Nevertheless, vertebral fractures are likely to be underestim ated since our ascertainment relied on a clinical indication for a medical imaging procedure. Among those aged 35 - 55 years, the fracture rate (perso ns per 10 000/year) in men was about double the rate in women (65 vs 35. Th e fracture rate was almost 7 times higher in women over 60 years versus wom en less than 55 years of age. In contrast, the fracture rate in men over 60 years was only 50% higher than in men less than 55 years of age (72 vs 104 ). Fracture rates in women and men were highest at the hip (28 and 10 respe ctively), spine (21 and 7), distal forearm (Colles') (18 and 4) and humerus (11 and 3), and were 3-4 times higher in women than men. These fractures a ccounted for 63% of all fractures in women and 32% in men. By contrast, the rate of lower leg and ankle fractures was less than 10 per 10 000 in both women and men and did not increase to the same extent with age. Hip fractur e rates appear high, particularly among the older age strata, compared with retrospective ascertainment in other populations. In Australia, as in many other countries, there is an increasing longevity of the population. The n umber of women aged 90 years and over increased by 32% and the number of me n of this age increased by 48% in the 5 years between the Australian nation al census of 1991 and 1996. Given stable fracture rates, the substantial he alth burden imposed by age-related fractures, particularly hip fractures, w ill continue to escalate in both women and men.