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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/23071

Title: Secular trends in fracture incidence in the UK between 1990 and 2012
Authors: van der Velde, Robert
Wyers, Caroline
Curtis, Elizabeth Mary
Geusens, Piet
Van den Bergh, Joop
de Vries, F.
Cooper, C.
van Staa, Tjeerd
Harvey, N. C.
Issue Date: 2016
Citation: OSTEOPOROSIS INTERNATIONAL, 27(11), p. 3197-3206
Abstract: We studied sex-specific incidence rates in a population 50 years or older in the UK. In the period of 1990-2012, the overall rate of fracture did not change, but there were marked secular alterations in the rates of individual fracture types, particularly hip and spine fractures in the elderly. 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. Methods We undertook a retrospective observational study using the Clinical Practice Research Datalink (CPRD), which contains the health records of 6.9 % of the UK population. Site-specific fracture incidence was calculated by calendar year for men and women separately, with fracture type categorised according to ICD-9 classification. Linear regression analysis was used to calculate mean annualised change in absolute incidence. For presentational purposes, mean rates in the first 5 years and last 5 years of the period were calculated. Results Overall fracture incidence was unchanged in both women and men from 1990 to 2012. The incidence of hip fracture remained stable amongst women (1990-1994 33.8 per 10,000 py; 2008-2012 33.5 per 10,000 py; p trend annualised change in incidence = 0.80) but rose in men across the same period (10.8 to 13.4 per 10,000 py; p = 0.002). Clinical vertebral fractures became more common in women (8.9 to 11.8 per 10,000 py; p = 0.005) but remained comparable in men (4.6 to 5.9 per 10,000 py; p = 0.72). Similarly, the frequency of radius/ulna fractures did not change in men (9.6 to 9.6 per 10,000 py; p = 0.25), but, in contrast, became less frequent in women (50.4 to 41.2 per 10,000 py; p = 0.001). Secular trends amongst fractures of the carpus, scapula, humerus, foot, pelvis, skull, clavicle, ankle, patella, and ribs varied according to fracture site and sex. Conclusion Although overall sex-specific fracture incidence in the UK population 50 years or over appears to have remained stable over the last two decades, there have been noticeable changes in rates of individual fracture types. Given that the impact of a fracture on morbidity, mortality, and health economy varies according to fracture site, these data inform the provision of healthcare services in the UK and elsewhere.
Notes: [van der Velde, R. Y.; Wyers, C. E.; van den Bergh, J. P. W.] VieCuri Med Ctr, Dept Internal Med, POB 1926, NL-5900 BX Venlo, Netherlands. [van der Velde, R. Y.; Wyers, C. E.; van den Bergh, J. P. W.] Maastricht Univ, Med Ctr MUMC, NUTRIM Sch Nutr Toxicol & Metab, Dept Internal Med, POB 616, NL-6200 MD Maastricht, Netherlands. [Curtis, E. M.; Cooper, C.; Harvey, N. C.] Univ Southampton, Southampton Gen Hosp, MRC Lifecourse Epidemiol Unit, Southampton SO16 6YD, Hants, England. [Geusens, P. P. M. M.] Maastricht Univ, Med Ctr MUMC, CAPHRI, Dept Internal Med,Subdiv Rheumatol, POB 616, NL-6200 MD Maastricht, Netherlands. [Geusens, P. P. M. M.; van den Bergh, J. P. W.] Hasselt Univ, Biomed Res Ctr, Agoralaangebouw D, B-3590 Diepenbeek, Belgium. [de Vries, F.] Univ Med Ctr Maastricht, Dept Clin Pharmacol & Toxicol, Maastricht, Netherlands. [de Vries, F.; van Staa, T. P.] Utrecht Inst Pharmaceut Sci, Dept Pharmacoepidemiol & Clin Pharmacol, Utrecht, Netherlands. [Cooper, C.] Univ Oxford, Inst Musculoskeletal Sci, NIHR Musculoskeletal Biomed Res Unit, Oxford OX3 7LD, England. [Cooper, C.; Harvey, N. C.] Univ Southampton, NIHR Southampton Nutr Biomed Res Ctr, Southampton SO16 6YD, Hants, England. [Cooper, C.; Harvey, N. C.] Southampton Univ Hosp, NHS Fdn Trust, Southampton SO16 6YD, Hants, England. [van Staa, T. P.] Univ Manchester, Hlth eRes Ctr, Manchester, Lancs, England.
URI: http://hdl.handle.net/1942/23071
DOI: 10.1007/s00198-016-3650-3
ISI #: 000388954600009
ISSN: 0937-941X
Category: A1
Type: Journal Contribution
Validation: ecoom, 2018
Appears in Collections: Research publications

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