Trends in hip fracture rates in Oslo 2012-2022 across sociodemographic characteristics

Historically, Oslo has experienced the world's highest hip fracture incidence. Preventive measures for falls and fractures have been implemented during the last decade, which has also seen demographic and societal changes. We aimed to describe trends in incidence rates of hip fracture in older adults in Oslo during the period 2012-2022 and to examine variation by sex, age, educational level, marital status and ethnic background.

Annually updated information for the population aged 70+ years in Oslo 2012-2022 from Statistics Norway was linked with information on hip fractures from the Norwegian Patient Registry. Age-adjusted annual incidence rates by demographic characteristics were estimated using Poisson regression.

A total of 7905 hip fractures occurred in the 11-year period. Age-adjusted (95% confidence interval (CI)) incidence rates in 2012 were 106 (91, 120) per 10,000 men and 198 (183, 214) per 10,000 women. Rates declined steeply over time. The lowest rates were observed in 2020-the year characterised by reduced activity level due to strict COVID-19 restrictions. By then, incidence rates had declined by 37% (95% CI: 31, 44) since 2012. The decline was consistent across age, marital status and educational level, except for a steeper decline in women with college and university education (P = 0.021). By 2022, incidence rates had rebounded to pre-pandemic levels and were 78 (95% CI: 68, 89) per 10,000 men and 141 (95% CI: 128, 154) per 10,000 women.

There was a dramatic decline in hip fracture incidence in Oslo during the last decade, which was consistent across sociodemographic subgroups.