Decreasing trend of hip fractures incidence in Italy between 2007 and 2014: epidemiological changes due to population aging

We analyzed hospitalization for hip fractures in elderly Italian people from 2007 to 2014. The number of fractures increased by 5.50% (women + 3.36; men + 12.9%) only due to people aged ≥ 85 years old. Incidence rates per 10,000 inhabitants decreased in all the age groups (65-74, 75-84, and also ≥ 85).

Purpose: To assess the burden of hip fractures in elderly Italian population moving from our previous researches documented a reduced incidence of hip fractures in Italian women aged 65-74 years old.

Methods: We analyzed national hospitalization records from 2007 to 2014 to compute age- and sex-specific rates at national and regional level.

Results: Seven hundred forty-one thousand six hundred thirty-three a total of 741,633 hospitalizations were observed in people ≥ 65 (women 568,203; men 173,430), with an overall increase of 5.50% over the 8-year period (females + 3.36; males + 12.9%). About 43.75% of total hip fractures were suffered by patients aged ≥ 85 years old. Women aged ≥ 85 accounted for 34.49% (n = 255,763) of total fractures. The incidence rate per 10,000 inhabitants in people aged 65-74 decreased from 28.65 to 25.31 in women (- 13.02%) and from 13.41 to 11.65 in men (- 13.12%). Incidence per 10,000 in people 75-84 decreased from 121.6 to 105.2 in women (- 13.49%) and from 55.8 to 47.5 in men (- 14.87%). Also, in people aged ≥ 85, the incidence per 10,000 declined from 300.99 to 268.72 in women (- 10.72%) and from 174.59 to 171.17 in men (- 1.96%). Standardized rates (SR) per 10,000 in the overall population aged 65 years old and over decreased between 2007 and 2014 from 22.9 to 20.1 and from 7.0 to 6.3 in women and men, respectively. Decreasing trends were documented in all Italian regions between 65 and 79 years old, with further reduction up to 84 years old in 16 regions out of 20. Region Lazio showed a decreasing trend also in people aged > 85 years old.

Conclusion: While the number of hospitalizations for hip fractures in Italy is still increasing due to the fractures occurring in people ≥ 85 years old, incidence rates are decreasing in all the age groups, including the oldest one, possibly because the number of subjects aged ≥ 85 is growing faster than the number of fractures.