When older adults break their hip bone, doctors are increasingly checking for weak bones and vitamin D deficiency—conditions that may have caused the fracture in the first place. This study looked at 20 years of medical records to see how often these bone health problems are found after hip fracture surgery. Researchers discovered that about 1 in 10 patients are newly diagnosed with weak bones within a year, and about 1 in 20 are found to have vitamin D deficiency. The findings suggest that screening for these conditions after a hip fracture is becoming more common and important for preventing future fractures.

The Quick Take

  • What they studied: How often doctors screen older adults for weak bones (osteoporosis) and vitamin D deficiency after hip fracture surgery, and how many patients are newly diagnosed with these conditions.
  • Who participated: Adults aged 65 and older who had hip fracture surgery between 2004 and 2024. The study reviewed medical records from a large network of hospitals and clinics.
  • Key finding: About 10% of hip fracture patients received a new diagnosis of weak bones within one year after surgery, and about 5-6% were diagnosed with vitamin D deficiency. Additionally, doctors are checking for these conditions much more often now than they did 20 years ago.
  • What it means for you: If you’re an older adult who breaks your hip, your doctor should check your bone strength and vitamin D levels. These conditions may have contributed to your fracture and treating them could help prevent future breaks. However, this study only shows what doctors are currently doing—it doesn’t prove that screening prevents more fractures.

The Research Details

Researchers looked at 20 years of medical records (2004-2024) from a large network of hospitals and clinics to track what happened to older adults who had hip fracture surgery. They searched for patients using medical billing codes and then looked at their records to see if they had weak bones or vitamin D deficiency before surgery, and whether they were diagnosed with these conditions at 1 month, 6 months, and 1 year after surgery.

The researchers compared different groups of patients to understand patterns over time. They used statistical tests to see if differences between groups were meaningful and not just due to chance. This approach allowed them to track how screening practices have changed over the past two decades.

This type of study is valuable because it shows real-world medical practice patterns rather than what doctors think they should do. By looking at actual patient records over 20 years, researchers can see how screening practices have evolved and identify how many patients might benefit from bone health testing after a hip fracture.

This study used a large, established medical database that includes records from many hospitals and clinics, which makes the findings more representative of general practice. However, the study only shows what doctors are currently screening for—it doesn’t prove that screening actually prevents future fractures. The data is limited to patients whose conditions were documented in medical records, so some cases may have been missed. The study doesn’t include information about whether patients actually received treatment for weak bones or vitamin D deficiency after being diagnosed.

What the Results Show

The study found a major shift in screening practices over 20 years. In 2004, about 75% of hip fracture patients had no prior history of weak bones or vitamin D deficiency. By 2024, this number dropped to about 50%, meaning doctors are now identifying these conditions more often before surgery.

After hip fracture surgery, new diagnoses were discovered at different time points. Within one month, about 3.7% of patients were newly diagnosed with weak bones and 2.1% with vitamin D deficiency. By six months, these numbers increased to 8.6% and 4.4% respectively. At one year after surgery, approximately 10.3% had a new diagnosis of weak bones and 5.6% had vitamin D deficiency.

These findings suggest that many older adults with hip fractures have underlying bone health problems that weren’t previously identified. The increase in diagnoses over time indicates that doctors are becoming more aware of the need to screen for these conditions in this patient population.

The study shows that the number of hip fracture surgeries recorded in the medical database increased significantly from 2004 to 2024, suggesting either more fractures occurring or better documentation of these procedures. The data also reveals that by 2024, half of all hip fracture patients had a documented history of weak bones or vitamin D deficiency before their fracture, indicating these are common underlying conditions in this age group.

This research builds on existing knowledge that weak bones and vitamin D deficiency are risk factors for hip fractures in older adults. The study’s main contribution is showing that screening practices have changed substantially over the past 20 years, with doctors now more likely to test for these conditions. The findings align with medical guidelines that recommend screening for bone health in older adults, particularly after a fracture.

The study only shows what doctors documented in medical records—some patients may have had these conditions but weren’t tested or the results weren’t recorded. The research doesn’t tell us whether patients who were diagnosed actually received treatment or whether treatment prevented future fractures. The study doesn’t account for differences in how aggressively different hospitals or doctors screen for these conditions. Additionally, the data may not represent all older adults with hip fractures, as it only includes patients in the specific medical network studied.

The Bottom Line

If you’re an older adult who has suffered a hip fracture, ask your doctor to check your bone strength (with a bone density test) and vitamin D levels as part of your recovery care. This screening should happen within the first few months after surgery. If you’re diagnosed with weak bones or vitamin D deficiency, discuss treatment options with your doctor, which may include vitamin D supplements, calcium, and medications to strengthen bones. (Confidence level: Moderate—screening is increasingly recommended, but more research is needed to prove it prevents future fractures.)

This information is most relevant for adults aged 65 and older, especially those who have experienced a hip fracture or are at risk for fractures. Family members of older adults should also be aware, as they can encourage screening and follow-up care. Healthcare providers should use this information to ensure they’re screening hip fracture patients for bone health problems. Younger adults with normal bone health may not need this level of screening unless they have specific risk factors.

Screening should ideally happen within the first month after hip fracture surgery, though it can be done up to a year afterward. If vitamin D deficiency or weak bones are found, it typically takes 3-6 months of treatment to see improvements in vitamin D levels, and 1-2 years to see meaningful improvements in bone density. However, preventing future fractures may take longer and depends on consistent treatment adherence.

Want to Apply This Research?

  • Track bone health screening dates and results: Record the date of your hip fracture surgery, the date you had your bone density test (DEXA scan), your vitamin D blood test results and dates, and any medications prescribed for bone health. Set reminders for follow-up tests (typically recommended annually or as directed by your doctor).
  • Use the app to set medication reminders for vitamin D supplements or bone-strengthening medications if prescribed. Create a checklist for bone health appointments and tests. Log dietary calcium intake (dairy products, leafy greens, fortified foods) and track physical activity, as both support bone health. Set goals for consistent medication adherence and follow-up appointments.
  • Establish a long-term tracking system that includes: (1) Medication adherence logs for bone health treatments, (2) Appointment reminders for follow-up bone density tests (usually every 1-2 years), (3) Vitamin D level tracking with test dates and results, (4) Fall prevention activities and any falls that occur, (5) Dietary calcium intake, and (6) Weight-bearing exercise frequency. Review this data monthly with your healthcare provider to adjust treatment as needed.

This research describes current medical screening practices for bone health after hip fractures in older adults. It does not provide medical advice or treatment recommendations. If you have experienced a hip fracture or are concerned about your bone health, consult with your healthcare provider or orthopedic surgeon for personalized evaluation and treatment. This study shows what doctors are currently screening for but does not prove that screening prevents future fractures. Individual medical decisions should be made in consultation with qualified healthcare professionals who understand your complete medical history.