ABSTRACT
In Europe, vertebral fracture incidence has increased three- to four-fold for women and more than four-fold for men during the last 30 years 1 . In Scandinavia the other fragility fracture, the femoral neck fracture, has shown a similar pattern, with a two- to three-fold increase in incidence for both men and women. The data are age-adjusted and therefore highlight the fact that there is a decrease in bone mass or bone quality from generation to generation 2 . Recently it has been shown that the incidence of femoral neck fractures in Europe varies more between countries than between sexes, which suggests important genetic or environmental factors in the causation of hip fracture 3 . To arrest or reverse the increases in osteoporotic fractures, effective general preventive regimens must be established. However, as the described changes in the incidence of vertebral and femoral neck fracture cannot be related to the menopause alone, other etiological factors must be investigated. In order to do this, basic knowledge of normal age-related changes in bone structure and function is crucial. Also, a description of the work pattern of the remodeling process in the load-bearing trabecular network is essential for understanding the age-related changes, and for choosing the most appropriate therapeutic and preventive regimens.
