Changing epidemiology of adult fractures in Scotland

Background: Fracture epidemiology in adults is changing but there is very little information about the rate of change or whether the change affects males and females equally. Methods: We have compared fracture incidence in two similar populations 50-60 years apart. A study of fractures in Dundee, Scotland and Oxford, England, in 1954-1958, was compared with a similar cohort of fractures in Edinburgh, Scotland, in 2010-2011. Fracture incidence in patients >35 years was recorded in both time periods. Results: The incidence of fractures increased by 50% between the two time periods, although the increase in males was only 5% compared with 85% in females. The spectrum of fractures has changed considerably, and there has been an increase in the incidence of both fragility and non-fragility fractures. Analysis showed an increased incidence of fall-related fractures in all age groups in both males and females. Interpretation: There has been a substantial change in the incidence of fractures in the last 50-60 years. These have been caused by greater longevity and by considerable social and economic changes.