Hip Fractures Among Older Adults

Hip fractures are serious fall injuries that often result in long-term functional impairment, nursing home admission and increased mortality.1 As our population ages, the number of hip fractures is likely to increase.

How big is the problem?

• In 2007, there were 281,000 hospital admissions for hip fractures among people age 65 and older.2
• Over 90% of hip fractures are caused by falling3, most often by falling sideways onto the hip.4
• In 1990, researchers estimated that by the year 2040, the number of hip fractures would exceed 500,000.5  However, since 2000, the annual number of hip fractures has remained relatively constant.
• From 1990 to 2006, hip fracture rates declined significantly in men age 85 and older and in women age 75 and older.6 It is not known what factors are contributing to this trend.
• In 1991, Medicare costs for hip fractures were estimated to be $2.9 billion.7

What outcomes are linked to hip fractures?

• A large proportion of fall deaths are due to complications following a hip fracture.8 One out of five hip fracture patients dies within a year of their injury.9
• Treatment typically includes surgery and hospitalization, usually for about one week2, and is frequently followed by admission to a nursing home and extensive rehabilitation.10
• Up to one in four adults who lived independently before their hip fracture  remains in a nursing home for at least a year after their injury.11

Who is at risk?

• Women sustain three-quarters of all hip fractures.2
• White women are much more likely to sustain hip fractures than are African-American or Asian women.12
• In both men and women, hip fracture rates increase exponentially with age.13 People 85 and older are 10 to 15 times more likely to sustain hip fractures than are those age 60 to 65.14
• Osteoporosis, a disease that makes bones porous, increases a person’s risk of sustaining a hip fracture.15 The National Osteoporosis Foundation estimates that more than 10 million people over age 50 in the U.S. have osteoporosis and another 34 million are at risk for the disease.16

How can hip fractures be prevented?

Hip fractures can be prevented by preventing falls. Fall prevention strategies include:

• Exercising regularly. It’s important that the exercise increase leg strength and improve balance and gradually become more challenging.17 Tai Chi programs are especially good.18
• Asking your doctor or pharmacist to review medicines—both prescription and over-the counter—to identify medicine with side effects and interactions that may cause dizziness or drowsiness.
• Having your vision checked by an eye doctor at least once a year and updating eyeglasses to maximize vision.  Consider getting a pair with single vision distance lenses for some activities such as walking outside.
• Making home safety improvements by reducing tripping hazards, adding grab bars inside and outside the tub or shower and next to the toilet, adding stair railings, and improving lighting.

Additional ways to lower hip fracture risk include:         

• Getting adequate calcium and vitamin D in your diet.
• Doing weight bearing exercise.
• Getting screened and treated for osteoporosis.

The most effective way to prevent fall injuries such as hip fractures is to combine exercise with other fall prevention strategies.19