The annual number of hip fractures in Sweden will double from year 2002 to 2050: projections based on local and nationwide data

Abstract

Background and purpose: The incidence and annual number of hip fractures have increased worldwide during the past 50 years, and projections have indicated a further increase. During the last decade, however, a down-turn in the incidence of hip fracture has been seen in the western world. We predicted the development of hip fractures in Sweden until the year 2050.

Methods: We reviewed surgical records for the period 2002-2012 in the city of Malmö, Sweden, and identified patients aged 50 years or more with a hip fracture. We estimated incidence rates by using official population figures as denominator and applied the rates to population projections each year until 2050. We also made projections based on our previously published nationwide Swedish hip fracture rates for the period 1987-2002. Since the projections are based on estimates, no confidence limits are given.

Results: During the period 2002-2012, there were 7,385 hip fractures in Malmö. Based on these data, we predicted that there would be approximately 30,000 hip fractures in Sweden in the year 2050. Use of nationwide rates for 2002 in the predictive model gave similar results, which correspond to an increase in the number of hip fractures by a factor of 1.9 (1.7 for women and 2.3 for men) compared to 2002.

Interpretation: The annual number of hip fractures will almost double during the first half of the century. Time trends in hip fractures and also changes in population size and age distribution should be continuously monitored, as such changes will influence the number of hip fractures in the future. Our results indicate that we must optimize preventive measures for hip fractures and prepare for major demands in resources.

Figure 1.

Projected annual Swedish population for the period 2010–2050, in total and divided into age classes.

Figure 2.

Projected numbers of hip fractures in Sweden for the period 2010–2050 based on: A. Nationwide Swedish hip fracture rates for the year 2002 in one-year age strata (≥ 50 years) (model i), average rates for the period 1987–2002 in one-year age strata (≥ 50 years) (model ii), and the rate for 2002 in only one stratum (≥ 50 years) (model iii). B. Local average rates for Malmö, Sweden, for the period 2002–2012 in 5-year age strata (≥ 50 years) (model iv) and in 2 age strata (65–79 years and ≥ 80 years) (model v). C. Previously published Swedish hip fracture rates for the period 1972–1981 presented in 5-year age strata (≥ 50 years) (model vi) (Hedlund et al. 1987), for the period 1982–1996 presented in 5-year age strata (≥ 50 years) (model vii) (Lofman et al. 2002), and for 2009 presented in 2 age strata (65–79 years and ≥ 80 years) (Nilson et al. 2013).