Unlocking the power of small changes to prevent hip fractures


A recent groundbreaking Australian study has uncovered the potential for simple, community-wide strategies to significantly reduce the occurrence of debilitating hip fractures.

Led by Distinguished Professor Tuan Nguyen, a renowned osteoporosis researcher from the University of Technology Sydney (UTS), this research sheds light on how minor lifestyle changes can yield substantial benefits for individuals and society as a whole.

Hip fractures, particularly among the elderly, carry dire consequences. Statistics reveal that approximately 37 per cent of men and 20 per cent of women do not survive the first year following a hip fracture. Beyond the increased risk of mortality, hip fractures bring forth considerable pain, suffering, loss of mobility and independence and increased healthcare expenses.

Professor Nguyen emphasised the urgency of taking proactive measures to enhance bone health, irrespective of whether an individual has osteoporosis or perceives these measures as having only minor personal benefits.

While pharmacologic treatments can reduce the risk of hip fractures by roughly 50 per cent in osteoporotic individuals, the majority of hip fractures occur in those without osteoporosis.

“Osteoporosis is a disease characterised by weak and brittle bones caused by bone loss,” Professor Nguyen explained. “Bone mineral density is modifiable, and even small improvements reduce the risk of a fracture.”

Lifestyle factors such as smoking, physical activity and nutrition, including vitamin D and dietary calcium intake, significantly influence bone health. Ceasing smoking, maintaining moderate physical activity and adopting a balanced diet all contribute to reducing bone loss.

The study, titled ‘Prevention of hip fractures: trade-off between minor benefits to individuals and large benefits to the community’, was recently published in the Journal of Bone and Mineral Research. Collaborators from The Garvan Institute of Medical Research and UNSW Sydney joined Professor Nguyen in this endeavour.

Researchers analysed data from the Dubbo Osteoporosis Epidemiology Study, one of the world’s longest-running osteoporosis studies, encompassing over 3,000 individuals aged 60 and above.

Over time, they tracked fracture incidence and risk factors. The results revealed a 3 per cent increase in bone mineral density between the first cohort in 1988-92 and the second in 1999-2001. During the same period, hip fractures decreased by a remarkable 45 per cent, a trend closely associated with a 10 per cent rise in bone mineral density.

The study aligns with British epidemiologist Geoffrey Rose’s concept that implementing population-based measures, offering small benefits to each individual, can yield substantial benefits for the community.

Professor Nguyen likens this to wearing a seatbelt, a practice that might seem to offer minimal personal benefit due to the low probability of a car accident. However, it is widely recognised that such a simple action saves lives within the community.

“Some people who are following medication regimens or engaging in lifestyle modification programs and notice a slight change in bone mineral density might believe that these measures hold little benefit for them. Nonetheless, even these minor effects can lead to a substantial reduction in fracture risk for the community,” Professor Nguyen emphasised.

The study’s findings have far-reaching implications for public health policymakers, medical professionals, and individuals seeking to reduce their hip fracture risk.

Dr Thach Tran, an epidemiologist and the study’s first author, highlights the importance of population strategies targeting low or moderate risk. Such approaches are likely to be more effective than solely focusing on high-risk individuals.


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