Trends in prevalence of fractures among adults in the United States, 1999-2020: a population-based study

Abstract

Background: Population data that examine recent national trends in the prevalence of fractures are lacking in the United States (US). Materials and Methods: Analyses were based on 1999–2020 data from National Health and Nutrition Examination Survey (NHANES). Primary outcomes included the prevalence of hip, wrist, and vertebral fractures among adults aged ≥50 years. Changes in the prevalence over time were determined by joinpoint regression analysis. We also described the variation by fracture subtypes, sociodemographic characteristics, and their combination. Results: For adults aged ≥50 years in NHANES 2017-March 2020, we estimated that there was 2.6 million Americans with hip fractures, 14.6 million Americans with wrist fractures, and 5.2 million Americans with vertebral fractures. The prevalence of wrist fractures significantly increased from 8.7% (7.4% to 9.9%) in 1999–2000 to 12.8% (11.6% to 14.1%) in 2017-March 2020 among adults aged ≥50 years (P for trend = 0.04); significant increases were also observed in fractures that occurred at age <50 years, non-Hispanic White, high family income groups, and several combination subgroups (e.g., fractures occurred at age <50 y among women). The prevalence of vertebral fractures increased from 2.2% (1.7% to 2.8%) in 1999–2000 to 4.6% (3.7% to 5.5%) in 2017-March 2020 among adults aged ≥50 years (P for trend = 0.02); significant increases were also observed in 50–64 years, women, non-Hispanic White, high family income groups and several combination subgroups (e.g., fractures that occurred at age <50 y among women). We did not observe significant trend changes in the prevalence of hip fractures among adults aged ≥50 years between 1999 and 2020. Conclusion: The estimated prevalence of wrist and vertebral fractures significantly increased among US adults aged ≥50 years from 1999 to 2020, although hip fractures did not significantly change.