Fractures in the elderly: epidemiology and demography

Osteoporosis and osteoporosis-related fractures are a major source of both morbidity and cost in the elderly, the fractures that are most commonly ass ociated with osteoporosis being those of the hip, the distal forearm and th e vertebrae, although it is believed that most other Fractures occurring in the elderly are also related to osteoporosis. In this review, the incidenc e of all types of fracture is described based on the available literature, and the foreseeable trends resulting from demographic changes are discussed . Emphasis is given to the epidemiology of hip fracture since this is the m ost serious consequence of osteoporosis. Hip fractures occur all over the w orld, most currently occurring in Western countries, mainly Europe and the USA, but it is expected that there will be a large increase in the number o f hip fractures in other countries because of demographic changes. The inci dence of hip fractures increases exponentially with age, resulting in a 1-y ear incidence of 1% in women aged 80 in Western countries. Most hip fractur es occur in women, but this is again partly due to demography, because of t he longer life expectancy of women. Wrist fractures occur more often in wom en and do not show the same increase with age as hip fractures. The inciden ce reaches a plateau at age 60-70. Vertebral fractures show a modest increa se with age and are again more common in women than men. The incidence of a ll other fractures increases modestly with age.