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Are Hip Fractures on the Rise in Older Women?

Are Hip Fractures on the Rise in Older Women?

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The incidence of hip fractures in older women in the U.S. is on the rise after more than a decade of decline, according to a Reuters report.

Researchers analyzed Medicare claims data from 2002 to 2015, from more than 2 million women, ages ≥65. They found that hip fracture rates declined each year from 2002 to 2012, but starting in 2013, hip fracture rates leveled off and were higher than expected.

Increases in fracture rates were prominent in women, ages 65-69, with an increase of 2.5%, and in women, ages 70-74, at an increase of 3.8% from 2014 through 2015.

The net results is more than 11,000 additional estimated hip fractures over the time periods, 2013 to 2015.

The U.S. Preventive Services Task Force (USPSTF) recommends that women (ages ≥65) get screened for osteoporosis with dual emission x-ray absorptiometry (DXA) to measure bone loss. Postmenopausal women age <65, with risk factors for osteoporosis, should also be screened. Risk factors include a family history of osteoporosis, diseases such as rheumatoid arthritis, the use of certain medications, and smoking and drinking alcohol.

One possible explanation is that use of DXA testing has steadily declined because DXA is used to diagnose osteoporosis before the first fracture occurs, and to monitor the skeletal effects of treatment, the researchers suggested.

Another factor that has led to the fracture rates to rise could be a decrease in osteoporosis treatment, they noted. This may be because fewer women are screened and diagnosed, or because patients may fear the rare but severe side effects that have been linked with osteoporosis drugs called bisphosphonates.

Jack Cush, MD, is the director of clinical rheumatology at the Baylor Research Institute and a professor of medicine and rheumatology at Baylor University Medical Center in Dallas. He is the executive editor of RheumNow.com. A version of this article first appeared on RheumNow, a news, information and commentary site dedicated to the field of rheumatology. Register to receive their free rheumatology newsletter.

Cush disclosed no relevant relationships with industry.

2018-01-20T10:00:00-0500

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