Аннотация:In this issue of The Lancet, Pekka Kannus and colleagues have tried to forecast the numbers of hip fractures that will occur over the next 30 years in Finland. They base their estimate on a combination of demographic projections and an extrapolation of current trends in age-specific fracture rates. This straightforward approach has the merit of being easy to unders tand, but it misses a potentially important extra dimension. Trends in diseases that have their origins long before the disorder becomes manifest commonly show strong cohort effects. Hip fracture falls into this category since it is influenced by mineralisation of the skeleton during growth in the first 20 years of life as well as by rates of bone loss and risk of falling in middle and old age. Hip fractures in Finland between 1970 and 1997 and predictions for the futureThe number of hip fractures in elderly Finnish men and women is increasing at a rate that cannot be explained merely by demographic changes. The precise reasons for this are not known, but deterioration in ageadjusted bone-mineral density and strength, with accompanying increase in the age-adjusted incidence of injurious falls of the elderly, could partly account for the development. Full-Text PDF
