Hip fracture rates are falling among older people for the first time
but hospital admissions are rising despite the apparent success of prevention
programs due to Australia’s aging population says research in the latest Medical Journal of Australia.
The study tracks a decade of hip fracture data among people aged 50
and over who were admitted to acute hospitals in NSW between July 1990 and June
2000. In the decade to June 2000, hip fracture admissions rose 41.9 per cent
among men and 31.2 per cent among women. Similar increases
have been observed worldwide with global numbers - estimated to be 1.3 million
in 1990 - expected to rise to between 7.3 million and 21.3 million by 2050. In
Australia hip fracture numbers are expected to double over 29 years and
quadruple in 56 years.
Study co-author, UNSW Professor Caroline Finch, said the global
increase in hip fractures is being driven by an ageing population profile in
western countries together with less active lifestyles, reduced bone and muscle
strength, more frequent medication use and inadequate levels of calcium and
“Increasing hip fracture admissions will put increasing financial
pressure on NSW acute hospitals because they account for nearly one per cent of
health service expenditure,” said Prof Finch, who heads the UNSW Injury Risk
Management Research Centre. “We found that average length of stay for hip
fracture admissions in NSW fell from 19 days to 14 days but this was accompanied
by a six per cent rise in patients being transferred to institutions such as
nursing homes and rehabilitation centres. In the long term, this is an
unsustainable strategy because hip fracture admissions will continue to rise in
line with an ageing population.”
Other key findings:
- Hip fracture rates among women are more than 2.5 times higher than in
- Hip fracture rates declined for in age groups except men aged 75 to 84 yrs and
women 85 yrs and over.
- Increasing admissions for hip fractures were highest in people aged 85 yrs and
over among men (75.8%) and women (61.3%).
- Women aged 65 to 74 years were the only age group for whom hip fracture
admissions declined (-10%).
Prof Finch said the decline in NSW hip fracture rates in the decade
to June 2000 might indicate the success of preventive programs such as promoting
awareness of risk factors for falls, environmental changes and promoting
physical activity in older people.
“The decline in hip fracture rates among women aged 50-74 and the
fall in the number of admissions in women aged 65-74 might also reflect
increasing use of hormone replacement therapy (HRT) known for its protective
effect and its role in reducing hip fracture risk.”
Prof Finch said priority should be given to evidence based preventive
measures, such as those aimed at promoting physical activity, improving
medication management and minimising environmental hazards at home and in acute
and residential care settings.
Prof Caroline Finch: (m) 0409 558 108 (bh) 02-9385 5361, Dan Gaffney: UNSW Faculty of Science media contact: mobile 0411 156