Incidence of Hip Fracture Over 4 Decades in the Framingham Heart Study

作者：Jay Swayambunathan, Abhijit Dasgupta, Philip S. Rosenberg, Marian T. Hannan, Douglas P. Kiel, Timothy Bhattacharyya · 发表于：JAMA Internal Medicine · 年份：2020 · DOI：10.1001/jamainternmed.2020.2975 · 被引用次数：67 · 研究领域：Bone health and osteoporosis research、Hip and Femur Fractures、Bone health and treatments

Importance: Age-adjusted hip fracture incidence is decreasing in the US. The decrease has been attributed to osteoporosis treatment, but the cause is unknown. Objective: To examine the decrease in hip fracture incidence over the past 40 years in the US. Design, Setting, and Participants: A population-based cohort study using participants in the Framingham Heart Study was conducted. A total of 4918 men and 5634 women were followed up prospectively for the first hip fracture between January 1, 1970, and December 31, 2010. Data were analyzed from May 1, 2019, to May 30, 2020. Main Outcomes and Measures: Incidence of hip fracture and contemporaneous prevalence of risk factors for hip fractures analyzed with age-period-cohort models. Results: The study contained more than 105 000 person-years in 10 552 individuals with a gradual shift toward the offspring participants in the 1980s and 1990s. Women represented more than 55% of the study sample over the years. Adjusted for age, the incidence of hip fracture decreased by 4.4% (95% CI, 6.8%-1.9%) per year from 1970 to 2010. Both period associations (P < .001) and birth cohort associations (P < .001) were statistically significant. For example, in persons aged 85 to 89 years, the incidence of hip fracture was 759 per 100 000 person-years in the offspring group compared with 2018 per 100 000 person-years in the original cohort. The decrease in hip fracture incidence was coincident with a decrease in smoking and heavy drinking. Smoking d...