More women report hip fractures earlier in life, research finds

Older women with low bone density are more likely to experience their first hip fracture in their 60s compared to older ages, according to research being presented Sunday at ENDO 2024, the Endocrine Society’s annual meeting in Boston, Mass.

“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 Avica Atri, M.D., an Internal Medicine resident physician at Jefferson Einstein Hospital in Philadelphia, Pa. “As the population over 60 swells in the United States, a large proportion of women will be at an increased risk of such fractures.”

Atri and her colleagues sought to understand how osteoporosis in the hip might increase the risk for fractures over time in specific age groups.

They used National Health and Nutrition Examination Survey (NHANES) data to identify women in the U.S. aged 60 or older with low bone mineral density (T-score ≤ -1) at the femur neck, based on DEXA scans from 2009-2018.

“Among these women, we found that the average bone mineral density in the hip declined along with a rise in the burden of osteoporosis, which increased from 18% to 21%,” Atri said. “However, this did not translate to an increase in the number of fragility hip fractures during this period and interestingly, there were 50% fewer self-reported fragility hip fractures in the 10-year span of the study.” The researchers found no significant increase in osteoporosis treatment during this time.

They also found that the number of women aged older than 70 years who experienced their first fragility hip fracture decreased during the study, compared with women aged 60-69 years. The women aged 60-70 years self-reported a first hip fracture 50% more. The researchers believe this might be due to prevention efforts already in place for the population aged above 70 years.

These findings, Atri said, highlight the need for earlier bone health awareness through routine primary care office visits. She also suggests additional measures to improve patient education on the benefits of nutrition, exercise, fall prevention, screening and treatment to curb these disparities.

“As the prevalence of osteoporosis nationally shows a worsening trend based on the analysis of the NHANES data, women are more likely to experience their first fragility hip fracture in their 60s rather than at older ages,” Atri said. “It’s never too early to think about bone health.”