Osteoporos Sarcopenia.  2018 Mar;4(1):16-21. 10.1016/j.afos.2018.03.003.

An updated hip fracture projection in Asia: The Asian Federation of Osteoporosis Societies study

  • 1Department of Pharmacology and Pharmacy, Centre for Genomic Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China.
  • 2The Osteoporosis Society of Hong Kong, Hong Kong, China.
  • 3Family Medicine Service and Menopause Unit, KK Women's and Children's Hospital, Singapore.
  • 4Osteoporosis Society Singapore, Singapore.
  • 5P. D. Hinduja Hospital, Mumbai, India.
  • 6Indian Society for Bone Mineral Research, India.
  • 7Department of Medicine & Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong, China.
  • 8Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea.
  • 9Korean Society of Osteoporosis, South Korea.
  • 10Department of Medicine, Subang Jaya Medical Centre, Selangor, Malaysia.
  • 11Malaysian Osteoporosis Society, Malaysia.
  • 12Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
  • 13Thai Osteoporosis Foundation, Thailand.
  • 14Department of Internal Medicine, Centro Hospitalar Conde S. Januário, Macau, China.
  • 15Osteoporosis Society of Macau, Macau, China.
  • 16Toranomon Hospital Endocrine Center, Tokyo, Japan.
  • 17Japan Osteoporosis Society, Japan. s-fujiwara@gentaikyo.or.jp
  • 18Department of Family Medicine, Institute of Gerontology, National Cheng Kung University Hospital, Tainan, Taiwan.
  • 19The Taiwanese Osteoporosis Association, Taiwan.
  • 20Department of Endocrinology, Key Laboratory of Endocrinology of Minister of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
  • 21Chinese Society of Osteoporosis and Bone Mineral Research, Chinese Medical Association, China.
  • 22Section of Rheumatology, Department of Medicine, University of Santo Tomas Faculty of Medicine and Surgery, Espana, Manila, Philippines.
  • 23The Osteoporosis Society of the Philippines Foundation, Inc, Philippines.
  • 24Health Management & Promotion Center, Hiroshima Atomic Bomb Casualty Council, Hiroshima, Japan.


Hip fracture is a major public health problem. Earlier studies projected that the total number of hip fracture will increase dramatically by 2050, and most of the hip fracture will occur in Asia. To date, only a few studies provided the updated projection, and none of them focused on the hip fracture projection in Asia. Thus, it is essential to provide the most up to date prediction of hip fracture in Asia, and to evaluate the total direct medical cost of hip fracture in Asia.
We provide the updated projection of hip fracture in 9 Asian Federation of Osteoporosis Societies members using the most updated incidence rate and projected population size.
We show that the number of hip fracture will increase from 1,124,060 in 2018 to 2,563,488 in 2050, a 2.28-fold increase. This increase is mainly due to the changes on the population demographics, especially in China and India, which have the largest population size. The direct cost of hip fracture will increase from 9.5 billion United State dollar (USD) in 2018 to 15 billion USD in 2050, resulting a 1.59-fold increase. A 2%-3% decrease in incidence rate of hip fracture annually is required to keep the total number of hip fracture constant over time.
The results show that hip fracture remains a key public health issue in Asia, despite the available of better diagnosis, treatment, and prevention of fracture over the recent years. Healthcare policy in Asia should be aimed to reduce the burden of hip fracture.


Hip fracture; Asia; Osteoporosis; Incidence
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