Women have been bombarded over the past 10 years with advertisements and articles that warn us about our risk of developing a hip fractures–the dreaded consequence of low bone density. To prevent this, we have been told that we should do all that we can to maintain our bone density by lifting weights, taking calcium and vitamin D supplements, or using hormones or bisphosphonates, like Fosamax (alendronate).

Well, maybe we are not in as much trouble as we thought.  Researchers reported on Wednesday in the Journal of the American Medical Association that rates of hip fractures have steadily declined in Canada since 1985. And this is not just a Canadian phenomenon. This study confirms the findings from a U.S. study, published in 2007 that found a similar decrease in the rate of hip fractures.

And the rates are not just falling a little bit. They are down 32% in women and 25% in men!  My first guess was maybe all those years of hormone replacement therapy (HRT) were worth something. But the decrease is in both women and men, so that rules out that possibility. Then I thought maybe it is the bisphosphonates, like Fosamax, that increase bone density. But they have only come on board relatively recently and the rates have been falling for 20 years.  Another guess is that women and men are smoking less, as smoking has been found to increase fracture risk, but the effect is not all that big. It is certainly NOT because there are less old people to fall. Could it be that we are all better nourished and overweight, stressing our bones to be stronger? Maybe. Basically, we don’t really know. It is however, good news.

It is also a reminder that sometimes we need to look at the long view. Maybe the notion of all postmenopausal women having their bone density tested early and taking drugs to prevent bone loss is all about trying to prevent a problem that is, in fact, getting better on its own, or that may not actually be the public health problem we have thought it was.

So, in sum: I am not sure what it is that we are doing right, but whatever it is we should keep on doing it!

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One Response to The Mystery of the Falling Hip Fracture Rates

  1. Ann S. Mills says:

    I’d been diagnosed with osteoporosis and took Fosomax for a couple of years, about a decade or more ago. Am 74, about 45 lbs overweight now and working at it. Was advised to take Boniva but first came down with polymyalgia and wanted to wait till that condition improved before going on Boniva. I appear strong and healthy as long as I have 10 mg prednisone and 240 mg etodolac daily to keep pain at bay. I feel so much better after reading your words on this subject.
    Thank you. ASM

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