Falling rates but projected rising numbers of fractures in elderly Norwegians: a study of fracture rates in the Norwegian patient registry from 2010 to 2021, extrapolated to 2041.

Abstract

Purpose:  Our aim was to calculate rates of major fractures by fracture location in elderly Norwegians over the years 2010 to 2021 and thereby estimate the volume of fractures in this population by 2041.

Methods:  We identified fractures in persons aged 65 years and over from the Norwegian Patient Registry. We summarized age- and sex-specific numbers of fractures and incidence rates by fracture location. Extrapolating adjusted incidence rates combined with population projections from Statistics Norway, we estimated the expected numbers of fracture cases for the following 20 years.

Results:  The total number of major fractures rose from 22,581 in 2010 to 27,596 in 2021. While the number of hip fractures was relatively stable (8,164 to 8,194 over the period), there were substantial increases in the number of fractures in the upper extremities, spine and pelvis, and lower extremities. Annual changes in incidence rates adjusted for age and sex were 0.6% (95% confidence interval [CI] 0.4-0.7), 1.2% (CI 0.9-1.4), 0.4% (CI 0.1-0.7), and -1.9% (CI -2.0 to -1.7) for upper extremity, spine and pelvis, lower extremity, and hip respectively. Extrapolating trends in incidence rates, we estimate a 64% (95% prediction interval 48-70) overall increase in the number of major fractures by 2041 compared with 2021, primarily due to the aging of the population.

Conclusion:  Incidence rates of hip fractures decreased over the period, while rates of other major fractures increased. We can expect a substantial increase in the number of fractures over the coming years, primarily due to the expected aging of the population.