The epidemiology of fractures of the proximal end of the femur. Change in the incidence among the population at risk in the city of Perugia, Italy between the periods 1975-77 and 1986-88.

The current interest in the epidemiology of fractures of the proximal end of the femur stems from a constant rise in their incidence in Western countries over the past several decades. Many authors believe the explanation could be an increased specific risk factor as well as an aging population. In the city of Perugia, Italy between 1975-77 and 1986-88 the incidence of these fractures increased by 108%, although the number of residents over 60 years of age increased by only 25%. An especially remarkable increase was seen in women over 70 and in intertrocherantic fractures. This information together with the National Institute of Statistics' (ISTAT) demographic forecasts regarding the aging Italian population lead to alarming epidemiologic projections for the next several decades. We propose two possible explanations for this increased risk factor: an increase in the frequency of falls suffered by elderly people and a deterioration in the quality of their bone.