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Differences in proximal femur bone density over two centuries

B Lees1, T Molleson, T R Arnett

  • 1Wynn Institute for Metabolic Research, London, UK.

Lancet (London, England)
|March 13, 1993
PubMed
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Modern women experience faster bone loss than those from two centuries ago, potentially explaining the rise in osteoporotic hip fractures. This study compared historical bone density to current levels, highlighting significant differences.

Area of Science:

  • Osteoporosis research
  • Paleopathology
  • Bone densitometry

Background:

  • Osteoporotic hip fractures are rising in Northern Europe, exceeding increases due to longer life expectancy.
  • Bone density is a critical factor in determining fracture risk.
  • Historical skeletal remains offer a unique opportunity to study long-term changes in bone health.

Purpose of the Study:

  • To compare the rate of bone loss in femora from the 18th-19th centuries with that of present-day women.
  • To investigate potential factors contributing to the increasing incidence of osteoporotic hip fractures.

Main Methods:

  • Dual-energy X-ray absorptiometry (DXA) was used to assess bone density.
  • Skeletal samples from 1729-1852 (Spitalfields, London) were compared to contemporary women's bone density.

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  • Analysis included pre-menopausal and post-menopausal groups, with sensitivity analysis for age at menopause.

    • Main Results:

    • Modern women exhibit a significantly greater rate of bone loss compared to women from two centuries ago (p < 0.05 pre-menopausally, p < 0.01 post-menopausally).
    • The accelerated bone loss in modern women was observed in the Ward's triangle region and persisted across different assumed menopausal ages.
    • These findings suggest historical differences in bone loss rates may contribute to contemporary hip fracture increases.

    Conclusions:

    • Accelerated bone loss in modern women compared to historical populations may partly explain the rising incidence of osteoporotic hip fractures.
    • Reduced physical activity in present-day women is a potential contributing factor to increased bone loss.
    • Further research is needed to elucidate the precise reasons for these observed differences in bone loss rates over time.