Abstract

Fractures contribute significantly to morbidity and mortality in older individuals. Among individuals age 60 years and older, the mortality-adjusted residual lifetime risk of fracture has been estimated to be 44–65% for women and 25–42% for men (1). After age 75, hip fractures are the most frequent fractures, and up to 50% of older individuals suffering a hip fracture will have permanent functional disability, 15–25% will require long-term nursing home care, and up to 20% will die within the first year after the event (2–4). The exponential increase in hip fractures after age 75 translates into an estimated 1 in 3 women, and 1 in 6 men, who will have sustained a hip fracture by their 90th decade (5). Consequently, hip fractures account for substantial and increasing health care expenses with annual costs in the United States projected to increase from 7.2 billion in 1990 to 16 billion in 2020 (6).