UBC Reports | Vol. 49 | No. 8 | Aug.
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
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
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/.