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Word Count: 473
The population of older men and women has been increasing and therefore the number of people with osteoporosis is increasing But in some countries the rate of hip fractures is rising faster than the population For example in Malmo Sweden the number of people older than 50 doubled since 1950 but the number of hip fractures increased seven-fold The reasons for this secular trend in increased hip fractures are not known but decreased physical activity may be playing a role When discussing the prevalence or incidence of osteoporosis one must distinguish between prevalence of fractures established osteoporosis and of low bone density Many women with low bone density do not have fractures Overall 21 of US postmenopausal women have osteoporosis and about 16 have had a fracture About 40 of women older than 80 have had a fracture of the hip vertebra arm or pelvis Men and women continue to lose bone mass as they age Therefore the prevalence of low bone mass increases as women age Incidence of hip fractures The incidence of hip fractures is the easiest to measure because almost all of the women and men who fracture their hip are hospitalized and the hospital records may be accessed The graph shows that white women have the highest incidence of fractures with a rate that increases exponentially after the age of 50 This graph is from Jacobsen SJ in AmericanJPublicHealth 80872 1990 Incidence and prevalence of vertebral fractures are much more difficult to ascertain than of hip fractures because many patients are unaware of the fractures Epidemiological studies must involve lateral spine xrays To make matters more complex the degree of compression necessary to define a vertebral fracture is not standardized In England the percentage of women aged 45 - 69 with vertebral fractures was 97 to 142 depending on the measurement method In a study of 16119 European men and women aged 50-79 the
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