Smoking Declines Precede Dip in Hip Fractures

Hip fractures in the United States and developed countries have been declining for over four decades. But why? Dr. Timothy Bhattacharyya, an orthopedic surgeon and head of Orthopedics Research for the Clinical Trials and Outcomes Branch of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, delved into the root cause of this phenomenon in a study published in July in JAMA Internal Medicine.

The new findings are based on a review of longitudinal data that dates back to the 1950s. The data was collected by Dr. Douglas Kiel, a co-author of the study and director of musculoskeletal research at Beth Israel Deaconess Medical Center. He is a leader in the field of musculoskeletal research and has amassed data from over 10,000 patients.

They found a correlation between the decline in hip fractures and a steady decline in smoking and to a lesser degree, a decline in heavy drinking. The decline, though, was not associated with the wide use of bisphosphonates.

“People have supposed that the incidence is declining because of the wide use of bisphosphonates. But this study shows it can't solely be attributed to treatment for osteoporosis. There has to be other factors that are leading to this precipitous decline,” Dr. Bhattacharyya said.

In this interview, Dr. Bhattacharyya provides some insights.

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REFERENCE

Swayambunathan J, Dasgupta A, Rosenberg PS, Hannan MT, Kiel DP, Bhattacharyya T. Incidence of Hip Fracture Over 4 Decades in the Framingham Heart Study. JAMA Intern Med. Published online July 27, 2020. doi:10.1001/jamainternmed.2020.2975