Epidemiology of hip fracture: Worldwide geographic variation.
ABSTRACT Osteoporosis is a major health problem, especially in elderly populations, and is associated with fragility fractures at the hip, spine, and wrist. Hip fracture contributes to both morbidity and mortality in the elderly. The demographics of world populations are set to change, with more elderly living in developing countries, and it has been estimated that by 2050 half of hip fractures will occur in Asia. This review conducted using the PubMed database describes the incidence of hip fracture in different regions of the world and discusses the possible causes of this wide geographic variation. The analysis of data from different studies show a wide geographic variation across the world, with higher hip fracture incidence reported from industrialized countries as compared to developing countries. The highest hip fracture rates are seen in North Europe and the US and lowest in Latin America and Africa. Asian countries such as Kuwait, Iran, China, and Hong Kong show intermediate hip fracture rates. There is also a north-south gradient seen in European studies, and more fractures are seen in the north of the US than in the south. The factors responsible of this variation are population demographics (with more elderly living in countries with higher incidence rates) and the influence of ethnicity, latitude, and environmental factors. The understanding of this changing geographic variation will help policy makers to develop strategies to reduce the burden of hip fractures in developing countries such as India, which will face the brunt of this problem over the coming decades.
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ABSTRACT: Hip fracture in the elderly population is a serious issue affecting the quality of life for many individuals and imposing a considerable public burden. The costs in terms of health care spending and mortality are well recognized. Numerous risk factors have been linked to the occurrence of hip fractures. Factors related to bone density and risk for falls have received the greatest attention. Hip fractures can be classified as extracapsular or intracapsular. Numerous surgical options are utilized to address hip fractures. Diagnosis of hip fractures is made through the combination of patient history, physical examination, and imaging modalities. Prevention programs emphasize a multidisciplinary approach.Topics in Geriatric Rehabilitation 01/2013; 29(4):272-276. · 0.14 Impact Factor
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ABSTRACT: Research examining the preventative effects of calcium and vitamin D supplementation has focused on children and females, leaving the effects on male bone mineral density (BMD) largely unexplored. Thus, the aim of this systematic review and meta-analysis is to examine the efficacy of calcium supplementation, with or without vitamin D for improving BMD in healthy males. Medline, EMBASE, SPORTDiscus, Academic Search Complete, CINHAHL Plus and PubMed databases were searched for studies including healthy males which provided participants calcium supplementation with or without vitamin D and used changes to BMD as the primary outcome measure. Between trial standardised mean differences of percentage change from baseline in BMD of femoral neck, lumbar spine, total body and total hip sites were calculated. Nine studies were included in the systematic review with six references totaling 867 participants contributing to the meta-analysis. Significant pooled effects size (ES) for comparison between supplementation and control groups were found at all sites included in the meta-analysis. The largest effect was found in total body (ES=0.644; 95% CI=0.406 to 0.883; p=0.000), followed by total hip (ES=0.483, 95% CI= 0.255 to 0.711, p=0.000), femoral neck (ES=0.402, 95% CI=0.233 to 0.570, p=0.000) and lumbar spine (ES=0.306, 95% CI=0.173 to 0.440,p=0.000). Limited evidence appears to support the use of calcium and vitamin D supplementation for improving BMD in older males. There is a need for high quality randomised controlled trials, especially in younger and middle-aged male cohorts and athletic populations to determine whether supplementation provides a preventative benefit.International journal of sport nutrition and exercise metabolism. 02/2015;
- Journal of Endocrinology, Metabolism and Diabetes of South Africa 08/2014; 18(1):21-32.