Epidemiology of Fragility Fractures and Social Impact

Abstract

Hip fracture is an important and debilitating condition in older people, especially in women. The epidemiological data vary between countries, but it is globally estimated that hip fractures currently affect around 18% of women and 6% of men. Although the age-standardised incidence is gradually decreasing in many countries, this is far outweighed by the ageing of the population. Thus, the global number of hip fractures is expected to increase. The direct costs associated with this condition are enormous since it requires a long period of hospitalisation and subsequent rehabilitation. Furthermore, hip fracture is associated with the development of other negative consequences, such as disability, depression, and cardiovascular diseases, with additional costs for society. At the same time, increasing attention is given to other osteoporotic fractures, such as vertebral ones, that are associated with negative health outcomes and enormous costs. In this chapter, we describe the most recent epidemiological data regarding hip and other osteoporotic fractures, with special attention to the well-known risk factors and conditions that seem relevant for determining fractures in older people. A specific part is dedicated to the social costs due to fractures. Although the costs of hip fracture are probably comparable to other common diseases with a high hospitalisation rate (e.g. cardiovascular disease), the other social costs (due to onset of new comorbidities, sarcopenia, poor quality of life, disability and mortality) are probably greater.

Characteristics of fallers who later sustain a hip fracture: a NOREPOS study

“…More than a third of elderly aged 65 years and older fall at least once a year [ 9 ]. Since most falls do not result in a fracture [ 10 ], there must be modifying factors connected to the individual, the living situation, or the environment that contribute to determine the outcome of a fall. The aim of this study was to explore the extent to which self-perceived health, participation in society, functional abilities, and use of different medications like psychotropics and analgesics as well as antihypertensives contribute, independently and in combination, to predict future hip fracture beyond self-reported falls.…”

Development of a data-driven case-mix adjustment model for comparison of hospital performance in hip fracture care

“…These patients generally show high morbidity and mortality rates. With increasing incidence of hip fractures due to the ageing population and longer life expectancies, the care of these patients will become an even greater challenge for health care providers and the society as a whole [2,3].…”

The healthcare system costs of hip fracture care in South Africa

“…However, the private healthcare sector provides only the minority of the population with healthcare [11]. Thirdly, we estimated direct healthcare costs incurred by the provider, excluding direct nonmedical and indirect costs, despite evidence of their impact on the total economic burden of HF [33]. These costs falling upon patients and their families can be catastrophic [31].…”