Fragility hip fractures among older women have become more common earlier in life, according to research presented at ENDO 2024, the Endocrine Society’s annual meeting in Boston, Mass.
The study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2009-2018 to identify trends in fragility hip fractures among U.S. women aged 60 or older with low bone mineral density (BMD) at the femur neck. The BMD was measured using dual-energy x-ray absorptiometry (DEXA) scans.
“Older women experience an increased risk of fragility hip fractures. These are hip fractures with minimal trauma or due to a fall from a standing height, and they are often deadly and disabling,” said one of the study's investigators, Avica Atri, M.D. “As the population over 60 swells in the United States, a large proportion of women will be at an increased risk of such fractures.”
Researchers analyzed data from NHANES for the years 2009-10, 2013-14, and 2017-18, including U.S. women aged 60 years or older with a bone mineral density (BMD) T-score of ≤ -1 at the femur neck. They excluded participants with missing BMD and fracture data. The analysis covered a range of medications and considered various patient characteristics such as age, gender, BMI, and blood test results. They tracked the number of patients who developed fragility hip fractures within five years of starting medication and compared groups by patient characteristics.
“Among these women, we found that the average bone mineral density in the hip declined, and the burden of osteoporosis increased from 18% to 21%,” Atri reported. “However, this did not translate to an increase in the number of fragility hip fractures during this period. Interestingly, there were 50% fewer self-reported fragility hip fractures over the 10-year span of the study.”
The study revealed that while the average BMD worsened, the prevalence of women with a T-score of ≤ -2.5 increased from 18.1% to 21.3%. Despite this, the proportion of women who experienced fragility hip fractures decreased significantly, from 2.4% in 2009-10 to 1.2% in 2017-18.
The researchers found a notable trend in the age groups affected by fragility hip fractures. The number of women aged 70 years or older who experienced their first fragility hip fracture decreased, while the number of women aged 60-69 years who self-reported a first hip fracture increased by 50%. This shift may be attributed to prevention efforts already in place for women over 70 years old.
“These findings highlighted the need for earlier bone health awareness through routine primary care office visits,” Atri said. “Additional measures to improve patient education on the benefits of nutrition, exercise, fall prevention, screening, and treatment are crucial to curb these disparities.”
The study suggested that despite worsening BMD trends, the incidence of fragility hip fractures declined, possibly due to increased awareness and prevention strategies. However, as the prevalence of osteoporosis showed a worsening trend, the need for early intervention and continuous education remained critical.
No conflicts of interest were disclosed.