To the Editor Age-adjusted rates of hip fractures have been found to decline gradually in the US and other developed countries,1-3 but remain increasing in developing areas.4 To learn more about the strikingly divergent patterns in hip fracture, we read with great interest the impressive Original Investigation by Swayambunathan and colleagues.1 This study found a declining trend in the incidence of hip fracture, which appeared to be associated with birth cohort effects and improvement in lifestyle factors, particularly the reduction in smoking and heavy drinking. This information is important for clinicians and patients. However, there are a few minor points that may help to contextualize findings from this study and contribute to further investigations to explore the factors influencing the decreased incidence of hip fractures.
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Shao L, Wu X, Huang W. Factors Associated With the Declining Trends of Hip Fractures. JAMA Intern Med. 2021;181(2):295–296. doi:10.1001/jamainternmed.2020.6480
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