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Related Concept Videos

Bone Disorders01:29

Bone Disorders

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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
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Related Experiment Video

Updated: Jul 29, 2025

Method and Instrumented Fixture for Femoral Fracture Testing in a Sideways Fall-on-the-Hip Position
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Explaining declining hip fracture rates in Norway: a population-based modelling study.

Helena Kames Kjeldgaard1,2, Kristin Holvik1, Bo Abrahamsen3

  • 1Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway.

The Lancet Regional Health. Europe
|May 22, 2023
PubMed
Summary

Hip fracture rates declined due to lifestyle changes and osteoporosis medications. Risk factor reductions explained two-thirds of this decline, while medications accounted for one-fifth, highlighting effective preventive strategies.

Keywords:
Epidemiologic methodsEpidemiologyHip fracturesOsteoporosisPublic health

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Area of Science:

  • Gerontology
  • Epidemiology
  • Public Health

Background:

  • Global hip fracture incidence shows a declining trend despite an aging population.
  • Understanding the factors driving this decline is crucial for effective public health policies and preventive measures.
  • This study investigates the impact of risk factors and osteoporosis treatments on hip fracture rates.

Purpose of the Study:

  • To quantify the contribution of temporal trends in major risk factors and osteoporosis treatment to the decline in hip fracture rates.
  • To analyze the impact of specific risk factors and medications on hip fracture incidence.
  • To inform targeted preventive strategies for hip fractures.

Main Methods:

  • Development of the Hip-IMPACT model, based on the IMPACT coronary heart disease models.
  • Application of sex- and age-stratified data for hip fracture numbers, treatment prevalence, and risk/preventive factors from 1999 and 2019.
  • Utilizing evidence on the independent relative risks of hip fracture associated with various factors.

Main Results:

  • The Hip-IMPACT model explained 91% of the hip fracture rate decline between 1999 and 2019.
  • Risk factor changes accounted for two-thirds of the decline, with increased body mass index (25%), physical activity (16%), and reduced smoking (11%) being significant contributors.
  • Osteoporosis medications (alendronate, zoledronic acid, denosumab) explained 11-6% of the decline, while increased hip replacements (17%) also played a role. Increased prevalence of type 2 diabetes and use of glucocorticoids, z-drugs, and opioids partially offset the decline.

Conclusions:

  • Reductions in major risk factors were the primary driver (two-thirds) of the observed decline in hip fractures from 1999 to 2019.
  • Osteoporosis medications contributed approximately one-fifth to the decline, indicating the importance of pharmacologic interventions.
  • The findings underscore the effectiveness of multifactorial approaches, including lifestyle modifications and medical treatments, in reducing hip fracture incidence.