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[Epidemiology of osteoporosis: the incidence of hip fracture decreased].

Osteoporosis is a frequent disease characterized by a high morbidity. Also a high rate of death has ben demonstrated for hip fractures and to a lesser extent for vertebral fractures. In the early 90s all the publications showed that the burden of fractures due to osteoporosis (and particularly hip fractures) would dramatically increase due to an incresed secular trend for the end of the Second World War and also due to the increase of life expectancy. However several epidemiological studies done in the USA but also in Europe (Scandinavian countries but also France) showed that the incidence of fractures and particularly hip fractures decreased over time. The hypotheses leading to these findings are not fully elucidated. Obviously the development of DXA scans and the use of bisphosphonates since the middle of the 90s played a role. Also the improvement of lifestyle and the decrease in the use of tobacco and alcohol also play a role for explaining these findings. Although these data are very encouraging, osteoporosis is still a severe disease characterized by a high rate of death. This latter point was demonstrated for hip and vertebral factures but also for all the major fractures.