A Secular Trend in Hip Fracture Incidence in East Germany

Wildner, Manfred; Casper, W; Bergmann, Karl E.

doi:10.1007/s001980050128

Cited by 23 publications

(19 citation statements)

References 37 publications

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“…In the former Eastern Germany an increase in the age-standardized hip fracture rate of 3% per year was observed from 1974 to 1989 [20]. Data for the former Western Germany are not available for this time period.…”

Section: Secular Trendsmentioning

confidence: 98%

Epidemiology of hip fractures

et al. 2018

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Background Hip fractures are regarded as a worldwide epidemic and a major public health concern. Changing risk factors, local differences and temporal trends contribute to the particular epidemiology of hip fractures. This overview gives a comprehensive insight into the epidemiology of hip fractures and reviews where German data have contributed to the literature. Methods The review of the epidemiology of hip fractures in Germany is based on a systematic literature search in PubMed. Information about the global epidemiology of hip fractures was provided by a selective literature review focusing on specific aspects of the epidemiology of hip fractures. Results Hip fracture rates vary more than 100-fold between different countries. In most high-income countries, a rise in age-standardized hip fracture rates was observed until the 1980s and 1990s and a decrease thereafter. Such a decrease has not been observed for Germany so far. Many factors, diseases and drugs have been found to be associated with hip fractures and there is some evidence that fracture risk in later life is already programmed during fetal life and early childhood. Of the hip fracture burden 50% occur in people with disability and in need of care. In nursing homes approximately 4 fractures can be expected in 100 women per year. In people with intellectual or developmental disabilities comparable risks of hip fracture occur 10–40 years earlier than in the general population. Incidence of disability, institutionalization and death are frequent consequences of hip fractures. Conclusion The epidemiology of hip fractures is characterized by a high burden of disease, local differences, temporal trends, well-defined high-risk populations and many established risk factors. Electronic supplementary material The online version of this article (10.1007/s00391-018-1382-z) contains supplementary material, which is available to authorized users.

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Section: Secular Trendsmentioning

confidence: 98%

Epidemiology of hip fractures

et al. 2018

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“…Gullberg and colleagues (1993) (31) 1950-1991 R(Malmo) þ1.4 þ3.5 -2.6 Bergstrom and colleagues (2009) (33) 1993-2005 R(Umea) -2.6 -0.85 Rosengren and colleagues (2012) (34) 1987-1996 N 0 0 Rosengren and colleagues (2012) (34) 1996-2002 N -1.4 -0.7 Central Europe Germany Wildner and colleagues (1999) (36) 1974-1989 R(East G) þ3.1 þ3.3 Icks and colleagues (2008) (37) 1995-2004 N þ0.2 þ0.9 þ0.4 Netherlands Boereboom and colleagues (1992) (38) 1972-1987 N þ2.3 þ3.6 Goettsch and colleagues (2007) (39) 1993-2002…”

Section: North Americamentioning

confidence: 99%

Secular Trends in Hip Fractures Worldwide: Opposing Trends East Versus West

Ballane

Cauley

Luckey

et al. 2014

Journal of Bone and Mineral Research

164

118

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Despite wide variations in hip rates fractures worldwide, reasons for such differences are not clear. Furthermore, secular trends in the age-specific hip fracture rates are changing the world map of this devastating disease, with the highest rise projected to occur in developing countries. The aim of our investigation is to systematically characterize secular trends in hip fractures worldwide, examine new data for various ethnic groups in the United States, evidence for divergent temporal patterns, and investigate potential contributing factors for the observed change in their epidemiology. All studies retrieved through a complex Medline Ovid search between 1966 and 2013 were examined. For each selected study, we calculated the percent annual change in age-standardized hip fracture rates de-novo. Although occurring at different time points, trend breaks in hip fracture incidence occurred in most Western countries and Oceania. After a steep rise in age-adjusted rates in these regions, a decrease became evident sometimes between the mid-seventies and nineties, depending on the country. Conversely, the data is scarce in Asia and South America, with evidence for a continuous rise in hip fracture rates, with the exception of Hong-Kong and Taiwan that seem to follow Western trends. The etiologies of these secular patterns in both the developed and the developing countries have not been fully elucidated, but the impact of urbanization is at least one plausible explanation. Data presented here show close parallels between rising rates of urbanization and hip fractures across disparate geographic locations and cultures. Once the proportion of the urban population stabilized, hip fracture rates also stabilize or begin to decrease perhaps due to the influence of other factors such as birth cohort effects, changes in bone mineral density and BMI, osteoporosis medication use and/or lifestyle interventions such as smoking cessation, improvement in nutritional status and fall prevention.

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“…Three out of four hip fractures affect women [1][2][3][4]. We had previously estimated hip fracture rates for East Germany prior to the German reunification, using hospital discharge statistics [5], and have also described a secular trend in hip fracture incidence from 1974 to 1989 [6]. The objective of the current study was to reassess hip fracture incidence 10 years after German reunification and compare incidence rates in former East and West Germany.…”

Section: Introductionmentioning

confidence: 99%

Hip Fracture Incidence in East and West Germany: Reassessement Ten Years after Unification

Wildner¹,

Clark

2001

Osteoporosis International

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The rising incidence of hip fractures is of world wide concern. In addition to the demographically aging populations world wide a secular trend of hip fracture incidence has been reported for various populations. The objective of the current study was to reassess hip fracture incidence ten years following German reunification and compare incidence rates in former East and West Germany. Data from the German hospital discharge diagnosis registry were used to compare rates in former East and West Germany. A reassessment of a secular trend was done with directly age-standardized rates of the population 60 years old and over. Significant differences were found between incidence rates in the East and West German states with higher rates in the West. Compared to earlier studies for East Germany, rate in East Germany have increased by on average annually 6% since reunification. This is a steep increase compared to the annual rise by about 3% between 1974 and 1989. Hip fracture incidence in East Germany thereby has doubled during the 25-year period from 1971 to 1996. Although the observed acceleration of a secular trend in East Germany probably has multiple causes, evidence suggests a significant influence of Western life style on hip fracture incidence.

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A Secular Trend in Hip Fracture Incidence in East Germany

Cited by 23 publications

References 37 publications

Epidemiology of hip fractures

Epidemiology of hip fractures

Secular Trends in Hip Fractures Worldwide: Opposing Trends East Versus West

Hip Fracture Incidence in East and West Germany: Reassessement Ten Years after Unification

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