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Abstract
A recent large-scale epidemiologic study disputes the idea that menopause is a pivotal event in the development of osteoporosis leading to hip fractures in white women. The study shows that the hip fracture rate for white women starts a steep climb between ages 40 and 44—15 to 20 years earlier than generally believed. The incidence curve appears to continue to rise smoothly, with no apparent inflection (signifying an accelerated risk) around the time of menopause or thereafter. National Institute on Aging (Bethesda, Md) epidemiologists Jacob A. Brody, MD; Mary E. Farmer, MD, MPH; and Lon R. White, MD, MPH, presented their findings in a recent paper (Am J Public Health1984;74:1397-1398). According to their calculations, postponing the early rise in hip fracture incidence in white women by about five years would reduce overall hip fractures in this high-risk group by about 50%. The investigators suggest that the best way to

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