Bone health is improving over time: data from Framingham cohorts
Amit Patel1, Jules D Allbritton-King1,2, Subrata Paul3
1Clinical and Investigative Orthopedics Surgery Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 10 Center Drive, Bldg. 10-CRC, Room 4-2339, MSC1498, Bethesda, MD, 20892, USA.
Archives of Osteoporosis
|September 15, 2023
Summary
Bone mineral density (BMD) has significantly improved in the USA over 30 years, potentially explaining the decline in hip fractures. This improvement is linked to healthier lifestyles in younger generations.
Area of Science:
- Gerontology
- Public Health
- Orthopedics
Background:
- Hip fractures are declining in the USA despite undertreatment of osteoporosis.
- The reasons for this decline remain unclear.
- Improved bone health may be a contributing factor.
Purpose of the Study:
- To investigate bone density trends in the USA over 30 years.
- To determine if bone mineral density (BMD) has improved across generations.
- To identify lifestyle factors associated with changes in BMD.
Main Methods:
- Analysis of bone mineral density (BMD) scans from 7216 subjects in the Framingham Heart Study across three generations.
- Comparison of mean femoral BMD between cohorts.
- Linear regression modeling, controlling for age, sex, BMI, and smoking rates.
Main Results:
- Mean BMD significantly increased in successive Framingham cohorts (p < 0.001).
- Later-born subjects exhibited higher BMD after age adjustment.
- Younger generations showed higher physical activity scores (p < 0.001) and lower smoking rates (p = 0.045).
Conclusions:
- Bone health, as measured by BMD, is improving in later US generations.
- Decreased smoking rates and increased physical activity contribute to improved bone health.
- These findings offer an explanation for the observed decline in hip fractures.
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