Age, cohort and period effects on hip fracture incidence: analysis and predictions from New Zealand data 1974-2007

Langley, John Desmond; Samaranayaka, Ari; Davie, Gabrielle; Campbell, Angela

doi:10.1007/s00198-010-1205-6

Cited by 46 publications

(42 citation statements)

References 29 publications

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“…The stable rates of hip fracture amongst women that we observed in the present study are consistent with many other studies of populations in the developed world, some of which have even documented a decline in age-and sex-adjusted rates [1]. Thus studies in USA [7], Canada [8], Austria [28], France [29], Australia [30] and New Zealand [31] have demonstrated declining age-and sex-specific rates of hip fracture over recent decades, often following an increase in rates in the decades prior. In the UK, a plateau in rates of age-adjusted hospital admission for hip fracture [32] was observed over the years 1989 to 1998.…”

Section: Discussionsupporting

confidence: 81%

Secular trends in fracture incidence in the UK between 1990 and 2012

et al. 2016

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Introduction-There is increasing evidence of secular changes in age-and sex-adjusted fracture incidence globally. Such observations broadly suggest decreasing rates in developed countries and increasing rates in transitioning populations. Since altered fracture rates have major implications for healthcare provision and planning, we investigated secular changes to age-and sex-adjusted fracture risk amongst the UK population aged 50 years or above from 1990 till 2012.

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Section: Discussionsupporting

confidence: 81%

Secular trends in fracture incidence in the UK between 1990 and 2012

et al. 2016

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“…(6,8) Langley and colleagues have observed as in our study that later cohorts have lower risk of hip fracture, but in contrast to our study, the period effects showed a steady increase in risk. (7) These authors explain the decline observed in later cohorts by increasing health and improvement in physical status of older people since the last century and explain the steady increase observed in period effect by an increased survival in very frail individuals. Moreover, a recent study in Switzerland showed that the decrease observed in women was attributed to a decrease in the incidence of hip fracture among institution-dwelling elderly women.…”

Section: Discussionmentioning

confidence: 96%

“…(1)(2)(3)(4)(5) However, few studies have attempted to assess if these declining rates can be attributed to changes occurring over a specific calendar period (period effect) or to changes affecting individuals born at a specific time (cohort effect). (6)(7)(8)(9) Period effects reflect changes occurring at a specific time and affect all individuals regardless of age. For example, the application of a new diagnostic technique or treatment for osteoporosis in a population might lead to a decrease in hip fracture rates explained by a period effect.…”

mentioning

confidence: 99%

Trends in hip fracture rates in Canada: An age-period-cohort analysis

Jean

O’Donnell

Lagacé

et al. 2013

Journal of Bone and Mineral Research

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Age-standardized rates of hip fracture in Canada declined during the period 1985 to 2005. We investigated whether this incidence pattern is explained by period effects, cohort effects, or both. All hospitalizations during the study period with primary diagnosis of hip fracture were identified. Age-and sex-specific hip fracture rates were calculated for nineteen 5-year age groups and four 5-year calendar periods, resulting in 20 birth cohorts. The effect of age, calendar period, and birth cohort on hip fracture rates was assessed using ageperiod-cohort models as proposed by Clayton and Schiffers. From 1985 to 2005, a total of 570,872 hospitalizations for hip fracture were identified. Age-standardized rates for hip fracture have progressively declined for females and males. The annual linear decrease in rates per 5-year period were 12% for females and 7% for males (both p < 0.0001). Significant birth cohort effects were also observed for both sexes (p < 0.0001). Cohorts born before 1950 had a higher risk of hip fracture, whereas those born after 1954 had a lower risk. After adjusting for age and constant annual linear change (drift term common to both period and cohort effects), we observed a significant nonlinear birth cohort effect for males (p ¼ 0.0126) but not for females (p ¼ 0.9960). In contrast, the nonlinear period effect, after adjustment for age and drift term, was significant for females (p ¼ 0.0373) but not for males (p ¼ 0.2515). For males, we observed no additional nonlinear period effect after adjusting for age and birth cohort, whereas for females, we observed no additional nonlinear birth cohort effect after adjusting for age and period. Although hip fracture rates decreased in both sexes, different factors may explain these changes. In addition to the constant annual linear decrease, nonlinear birth cohort effects were identified for males, and calendar period effects were identified for females as possible explanations. ß

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“…Life expectancy has increased in China (23) and increased rates of hip fracture might reflect improved medical care resulting in longer survival of frail elders who are at increased risk of hip fractures. (24) However, paradoxically, studies indicate that the health status of elderly in China improved between 1990 and 2002. (23) The increased risk was also greater for women than men, now more closely resembling the greater ratio of women to men observed in Western countries; the reason for this pattern of change is not clear.…”

Section: Discussionmentioning

confidence: 99%

“…Our data derive from two surveys and, therefore, we are unable to determine how much of the change is because of a cohort effect: decreases in rates in successive cohorts or decreases because of changes in conditions between the two periods of time. (24) Assuming no changes in the age-specific incidence of hip fractures around the world, Cooper (2) estimated that 51% of the world's hip fractures would occur in Asia by 2050. However, the age-specific rates of hip fracture are decreasing in northern Europe and North America.…”

Section: Journal Of Bone and Mineral Researchmentioning

confidence: 99%

Rapidly increasing rates of hip fracture in Beijing, China

Xia

et al. 2011

Journal of Bone and Mineral Research

176

112

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The age-specific rates of hip fractures have been declining in most countries in the West but a few studies suggest that the rates might be increasing in areas of Asia that are undergoing urbanization. We previously conducted a population-based study of hip fracture rates in Beijing, China, in 1990 to 1992 that included validation of hip fracture cases. Using a similar approach to validate cases, we estimated the age-specific hip fracture rates in Beijing, China, for 2002 to 2006. Specifically, we obtained hospital discharge data for hip fractures that were reported to the Beijing Bureau of Public Health. To confirm the diagnoses, Beijing residence, and find cases missed by the public records we checked individual cases in the public health records against medical records in a random sample of Beijing hospitals. The rates from public health data were adjusted for these under-and overestimations. We found that between 1990 and 1992 and 2002 and 2006, the adjusted age-specific rates of hip fracture over age 50 years increased 2.76-fold (95% confidence interval [CI], 2.68-2.84) in women and 1.61-fold (95% CI, 1.56-1.66) in men. Over age 70 years, the age-specific rates increased 3.37-fold (95% CI, 3.28-3.47) in women and 2.01-fold (95% CI, 1.95-2.07) in men. From 2002 to 2006, the rates over age 50 years increased 58% in women and 49% in men. We conclude that the rate of hip fracture has been rising very rapidly in Beijing, China. Therefore, the burden of hip fractures may be shifting rapidly from the West to urbanizing areas of the East. ß

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Age, cohort and period effects on hip fracture incidence: analysis and predictions from New Zealand data 1974-2007

Cited by 46 publications

References 29 publications

Secular trends in fracture incidence in the UK between 1990 and 2012

Secular trends in fracture incidence in the UK between 1990 and 2012

Trends in hip fracture rates in Canada: An age-period-cohort analysis

Rapidly increasing rates of hip fracture in Beijing, China

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