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Recent hip fracture trends in Sweden and Denmark with age-period-cohort effects

SUMMARY: This study used nationwide hip fracture data from Denmark and Sweden during 1987–2010 to examine effects of (birth) cohort and period. We found that time trends, cohort, and period effects were different in the two countries. Results also indicated that hip fracture rates may increase in th...

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Autores principales: Rosengren, B. E., Björk, J., Cooper, C., Abrahamsen, B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer London 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206266/
https://www.ncbi.nlm.nih.gov/pubmed/27647528
http://dx.doi.org/10.1007/s00198-016-3768-3
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author Rosengren, B. E.
Björk, J.
Cooper, C.
Abrahamsen, B.
author_facet Rosengren, B. E.
Björk, J.
Cooper, C.
Abrahamsen, B.
author_sort Rosengren, B. E.
collection PubMed
description SUMMARY: This study used nationwide hip fracture data from Denmark and Sweden during 1987–2010 to examine effects of (birth) cohort and period. We found that time trends, cohort, and period effects were different in the two countries. Results also indicated that hip fracture rates may increase in the not so far future. INTRODUCTION: The reasons for the downturn in hip fracture rates remain largely unclear but circumstances earlier in life seem important. METHODS: We ascertained hip fractures in the populations ≥50 years in Denmark and Sweden in national discharge registers. Country- and sex-specific age-period-cohort (APC) effects during 1987–2010 were evaluated by log-likelihood estimates in Poisson regression models presented as incidence rate ratios (IRR). RESULTS: There were 399,596 hip fractures in SE and 248,773 in DK. Age-standardized hip fracture rate was stable in SE men but decreased in SE women and in DK. Combined period + cohort effects were generally stronger in SE than DK and in women than men. IRR per period ranged from 1.05 to 1.30 in SE and 0.95 to 1.21 in DK. IRR per birth cohort ranged from 1.07 to 3.13 in SE and 0.77 to 1.67 in DK. Relative period effects decreased with successive period in SE and described a convex curve in DK. Relative cohort effects increased with successive birth cohort in both countries but with lower risks for DK women and men and SE women born around the 1930s (age 75–86 years today and responsible for most hip fractures) partly explaining the recent downturn. Men and women born thereafter however seem to have a higher hip fracture risk, and we expect a reversal of the present decline in rates, with increasing hip fracture rates in both Denmark and Sweden during the upcoming decade. CONCLUSIONS: Time trends, cohort, and period effects were different in SE and DK. This may reflect differences in general health as evident in known differences in life expectancy, healthcare organization, and prevention such as use of anti-osteoporosis drugs. Analyses indicate that hip fracture rates may increase in the not so far future. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00198-016-3768-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-52062662017-01-18 Recent hip fracture trends in Sweden and Denmark with age-period-cohort effects Rosengren, B. E. Björk, J. Cooper, C. Abrahamsen, B. Osteoporos Int Original Article SUMMARY: This study used nationwide hip fracture data from Denmark and Sweden during 1987–2010 to examine effects of (birth) cohort and period. We found that time trends, cohort, and period effects were different in the two countries. Results also indicated that hip fracture rates may increase in the not so far future. INTRODUCTION: The reasons for the downturn in hip fracture rates remain largely unclear but circumstances earlier in life seem important. METHODS: We ascertained hip fractures in the populations ≥50 years in Denmark and Sweden in national discharge registers. Country- and sex-specific age-period-cohort (APC) effects during 1987–2010 were evaluated by log-likelihood estimates in Poisson regression models presented as incidence rate ratios (IRR). RESULTS: There were 399,596 hip fractures in SE and 248,773 in DK. Age-standardized hip fracture rate was stable in SE men but decreased in SE women and in DK. Combined period + cohort effects were generally stronger in SE than DK and in women than men. IRR per period ranged from 1.05 to 1.30 in SE and 0.95 to 1.21 in DK. IRR per birth cohort ranged from 1.07 to 3.13 in SE and 0.77 to 1.67 in DK. Relative period effects decreased with successive period in SE and described a convex curve in DK. Relative cohort effects increased with successive birth cohort in both countries but with lower risks for DK women and men and SE women born around the 1930s (age 75–86 years today and responsible for most hip fractures) partly explaining the recent downturn. Men and women born thereafter however seem to have a higher hip fracture risk, and we expect a reversal of the present decline in rates, with increasing hip fracture rates in both Denmark and Sweden during the upcoming decade. CONCLUSIONS: Time trends, cohort, and period effects were different in SE and DK. This may reflect differences in general health as evident in known differences in life expectancy, healthcare organization, and prevention such as use of anti-osteoporosis drugs. Analyses indicate that hip fracture rates may increase in the not so far future. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00198-016-3768-3) contains supplementary material, which is available to authorized users. Springer London 2016-09-19 2017 /pmc/articles/PMC5206266/ /pubmed/27647528 http://dx.doi.org/10.1007/s00198-016-3768-3 Text en © The Author(s) 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Rosengren, B. E.
Björk, J.
Cooper, C.
Abrahamsen, B.
Recent hip fracture trends in Sweden and Denmark with age-period-cohort effects
title Recent hip fracture trends in Sweden and Denmark with age-period-cohort effects
title_full Recent hip fracture trends in Sweden and Denmark with age-period-cohort effects
title_fullStr Recent hip fracture trends in Sweden and Denmark with age-period-cohort effects
title_full_unstemmed Recent hip fracture trends in Sweden and Denmark with age-period-cohort effects
title_short Recent hip fracture trends in Sweden and Denmark with age-period-cohort effects
title_sort recent hip fracture trends in sweden and denmark with age-period-cohort effects
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206266/
https://www.ncbi.nlm.nih.gov/pubmed/27647528
http://dx.doi.org/10.1007/s00198-016-3768-3
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