UBC Reports | Vol. 49 | No. 8 | Aug. 7, 2003

Global Epidemic of Hip Fractures

UBC leads international research team

By Hilary Thomson

It’s a life-threatening condition that affects 1.6 million people around the world every year, costs $650 million annually for Canada to manage and carries a mortality rate of 20 per cent in the first year.

The statistics may look like data on infectious disease, but in fact, they describe hip fracture. A health problem that scientists are calling an epidemic, hip fractures are the focus of a new international research project led by UBC researchers and members of the Vancouver Coastal Health Research Institute (VCHRI), a joint venture in research between UBC and Vancouver Coastal Health Authority.

Karim Khan, assistant professor of Family Practice and Human Kinetics, is co-ordinating the project with input from researchers in Australia, Finland and UBC investigators in disciplines that include law, psychology and bioengineering. The project is the first to have a research team that spans many disciplines and is focused on prevention.

"Many people accept that falls and hip fractures are inevitable among older people, but new evidence shows they can be prevented," says Khan, an expert in bone health.

Hip fracture primarily affects people 60 years and older with lighter-boned women suffering four times the number of fractures as men. Aging baby boomers are predicted to create a three-fold increase in the number of hip fractures by 2050. Even without demographic influence, the average individual risk is increasing rapidly worldwide.

"We have theories as to why the incidence is climbing over and above the rate explained by aging," says Khan. "However, if the trend continues it will choke health systems the world over."

What is known, he says, is that about 40 per cent of all hip fracture patients suffer from osteoporosis, a bone-thinning disease. The resulting skeletal fragility combined with factors such as impaired vision and reaction time, faulty balance, low blood pressure, muscle weakness and inappropriate use of medication all contribute to falls.

Risk factors that the researchers will explore include the effects of poor nutrition during periods of war and economic depression as well as increasingly sedentary lifestyles that result in lower, more fragile bone mass. Investigators will also look at previously unexplored causes such as living arrangements and educational status as well as legal perspectives relating to safety standards.

Evaluating all risk factors will allow doctors to better predict fractures.

The research team was created following a June international workshop at UBC’s Peter Wall Institute for Advanced Studies that promotes innovative interdisciplinary research. The team is now applying for funding for a variety of investigations that will span five years.

UBC team members include Prof. Anne Martin-Matthews, of Social Work and Family Studies, who will lead a research group focused on socio-cultural risk factors and barriers to behaviour change among patients and health-care professionals. Law Assoc. Prof Janis Sarra will examine health law connections and Orthopedics Assoc. Prof. Heather McKay will direct a team promoting skeletal strength at the crucial hip site.

Khan, together with Assoc. Prof. Janice Eng, of Rehabilitation Sciences, will develop their earlier studies showing that resistance weight training and agility training can dramatically decrease fall risk in 80-year old women who are stroke survivors or who have low bone mass, two groups likely to experience hip fracture.

Investigators conducting clinical research will work from the Bone Health Research Lab, located at VCHRI. The lab, which houses several bone measurement devices and a falls research unit, serves as a research base for McKay, Khan, and Eng, who are VCRI members.

The international research project will be part of the proposed Centre for Hip Health: A Lifespan Approach, led by Assoc. Prof. Tom Oxland, Canada Research Chair in Biomedical Engineering. The centre would also be located at VCHRI.

For more information visit http://www.familymed.ca/hiphealth/.