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Depolymerisation of kraft lignin under hydrothermal conditions was investigated at short residence times (1–12 min) with glycerol being used as a capping agent. The weight average molecular weight (M w) of the products decreased within the first minute of residence time, with the inter-unit ether linkages breaking accordingly. Furthermore, the M w of the product fractions decreased at increasing residence times, while the char yield increased. Short residence times thus appear to be beneficial for mitigating the formation of char. Also, addition of NaOH reduced the yield of char. Although the addition of glycerol caused a decrease in the M w of the products, it seemed to increase the yield of char and therefore might not be a suitable capping agent for kraft lignin depolymerisation.

Objectives The aim of the study was to examine the associations between heavy physical workload among middle-aged and older workers and disability pension due to any diagnosis, as well as musculoskeletal, psychiatric, cardiovascular or respiratory diagnoses. The population-based design made it possible to examine dose–response and potential gender differences in the associations. Methods About 1.8 million men and women aged 44–63 years and registered as living in Sweden in 2005 were followed regarding disability pension during 2006–2016, until ages 55–65 years. Mean values of physical workload and job control, estimated through gender-specific job-exposure matrices (JEMs), were assigned to individuals through their occupational titles in 2005. Exposure values were ranked separately for women and men and divided into quintiles. Associations were analyzed with Cox proportional-hazards regression. Results The analyses showed robust, dose–response associations between physical workload and disability pension with a musculoskeletal diagnosis in both genders: the adjusted hazard ratio and 95% confidence interval for those with the heaviest exposure was 2.58 (2.37–2.81) in women and 3.34 (2.83–3.94) in men. Dose–response associations were also seen in relation to disability pension with a cardiovascular or a respiratory diagnosis, though the hazard ratios were smaller. Physical workload was not associated with disability pension with a psychiatric diagnosis after adjustment for job control. Conclusion This study of the entire Swedish population of middle-aged and older workers suggests that higher degrees of physical workload may increase the risk of disability pension overall, and specifically with musculoskeletal, cardiovascular or respiratory diagnosis, in both women and men.

Supplemental material, sj-docx-1-sjp-10.1177_14034948221081628 for Occupational differences in mortality and life expectancy persist after retirement and throughout life by Ebeling Marcus, Ahlbom Anders, Gustavsson Per and Modig Karin in Scandinavian Journal of Public Health

The scientific debate following the initial formulation of the “bad luck” hypothesis in cancer development highlighted how measures based on analysis of variance are inappropriately used for risk communication. The notion of “explained” variance is not only used to quantify randomness, but also to quantify genetic and environmental contribution to disease in heritability coefficients. In this paper, we demonstrate why such quantifications are generally as problematic as bad luck estimates. We stress the differences in calculation and interpretation between the heritability coefficient and the population attributable fraction, the estimated fraction of all disease events that would not occur if an intervention could successfully prevent the excess genetic risk. We recommend using the population attributable fraction when communicating results regarding the genetic contribution to disease, as this measure is both more relevant from a public health perspective and easier to understand. Electronic supplementary material The online version of this article (10.1007/s10654-019-00573-8) contains supplementary material, which is available to authorized users.

Background Stroke incidence has declined during the past decades. Yet, there is a concern that an ageing population together with improved survival after stroke will result in a raised proportion of the population who have experienced a stroke, as well as increasing incidence rate of recurrent strokes, and, absolute numbers of strokes. The objectives of this study were to investigate how the age specific incidence rates of recurrent strokes have developed in relation to the incidence rates of first strokes and how the postponement in age look like, and to see how the prevalence proportion of stroke as well as the absolute number of incident strokes has changed over time. Methods This study includes the total Swedish population born 1890–1954 living in Sweden from 1987. Stroke was identified through hospital admissions and deaths in national health registers (mandatory for all hospitals in Sweden). Age specific incidence rates were calculated for first, second, all recurrent, and all strokes for each calendar year between 1994 and 2014 for each age between 60 and 104 years. The proportion in the population with a history of stroke up to 7 years back in time was also calculated for different age groups and for different calendar years. Results Not only the incidence rate of first stroke but also of recurrent strokes have declined. The declines are evident in all ages up to 90 years of age, but not in ages above 90 years. Despite improved survival in stroke, the prevalence proportion has declined over the period and was around 3% in 2014 (somewhat higher for men than women). Even incident cases of stroke in absolute number has declined. Conclusions Decreasing incidence rates of stroke have offset an increase in both absolute and relative numbers of stroke that otherwise would have taken place due to improved survival and an ageing population. The decline in stroke recurrence has been as strong as the decline in first strokes. Electronic supplementary material The online version of this article (10.1186/s12877-019-1050-1) contains supplementary material, which is available to authorized users.

Supplemental Digital Content is available in the text., Background: Hip fractures are common and severe conditions among older individuals, associated with high mortality, and the Nordic countries have the highest incidence rates globally. With this study, we aim to present a comprehensive picture of trends in hip fracture incidence and survival in the older Swedish population stratified by education, birth country, and comorbidity level. Methods: This study is based on a linkage of several population registers and included the entire population over the age of 60 living in Sweden. We calculated age-standardized incidence rates for first and recurrent hip fractures as well as age-standardized proportions of patients surviving 30 and 365 days through the time period 1998 to 2017. We calculated all outcomes for men and women in the total population and in each population stratum. Results: Altogether, we observed 289,603 first hip fractures during the study period. Age-standardized incidence rates of first and recurrent fractures declined among men and women in the total population and in each educational-, birth country-, and comorbidity group. Declines in incidence were more pronounced for recurrent than for first fractures. Approximately 20% of women and 30% of men died within 1 year of their first hip fracture. Overall, survival proportions remained constant throughout the study period but improved when taking into account comorbidity level. Conclusions: Hip fracture incidence has declined across the Swedish population, but mortality after hip fracture remained high, especially among men. Hip fracture patients constitute a vulnerable population group with increasing comorbidity burden and high mortality risk.

Background This aggregated population study investigated the impact of the seemingly quasi-randomly assigned school winter holiday in weeks 6–10 (February to early March) on excess mortality in 219 European regions (11 countries) during the COVID-19 pandemic in the spring 2020. A secondary aim was to evaluate the impact of government responses to the early inflow of infected cases. Methods Data on government responses weeks 8–14 were obtained from the Oxford COVID-19 Government Response Tracker. Regional data on total all-cause mortality during weeks 14–23 in 2020 were retrieved from Eurostat and national statistical agencies and compared with the average mortality during same period 2015–2019. Variance-weighted least square regression was used with mortality difference as dependent variable with adjustment for country, population density and age distribution. Results Being a region with winter holiday exclusively in week 9 was in the adjusted analysis associated with 16 weekly excess deaths [95% confidence interval (CI) 13–20] per million inhabitants during weeks 14–23, which corresponds to 38% of the excess mortality in these regions. A more stringent response implemented in week 11, corresponding to 10 additional units on the 0–100 ordinal scale, was associated with 20 fewer weekly deaths (95% CI 18–22) per million inhabitants. Conclusions Winter holiday in week 9 was an amplifying event that contributed importantly to the excess mortality observed in the study regions during the spring 2020. Timely government responses to the resulting early inflow of cases reduced the excess in mortality.

Kraft lignin depolymerisation using hydrothermal liquefaction suffers from the formation of char, resulting in a decreased product yield as well as causing operational problems. While this may be mitigated by the addition of capping agents such as phenol and isopropanol, other reaction parameters, for example reaction time and temperature, are also important for the product yields. In this work, the effect of short reaction times on the hydrothermal liquefaction of kraft lignin in an alkaline water and isopropanol mixture was investigated at 1–12 min and 290 °C. The results show that there were swift initial reactions: the major ether bonds in the lignin were broken within the first minute of reaction, and the molecular weight of all product fractions was halved at the very least. Longer reaction times, however, do not cause as pronounced structural changes as the initial reaction, indicating that a recalcitrant carbon-carbon skeleton remained in the products. Nevertheless, the yields of both char and monomers increased slowly with increasing reaction time. The swift initial depolymerising reactions were therefore followed by slower repolymerisation as well as a slow formation of monomers and dimers, which calls for careful tuning of the reaction time.

BackgroundThis aggregated population study of 219 regions in 11 European countries investigated the effect of the seemingly quasi-randomly assigned school winter holiday week on excess mortality associated with the COVID-19 pandemic during spring 2020. A secondary aim was to evaluate the impact of stringency and timing of the government responses to the early inflow of infected cases.MethodsRegional data on mortality week 14-23 in 2020 compared with the same period 2015-2019 were retrieved from Eurostat and national statistical agencies. Data on initial government responses were obtained from the Oxford COVID-19 Government Response Tracker. Variance-weighted least square regression was used with further adjustment for population density and age distribution.ResultsBeing a region with winter holiday exclusively in week 9 was in the adjusted analysis associated with 16 weekly excess deaths (95% confidence interval 13 to 20) per million inhabitants, which corresponds to 38% of the excess mortality during the study period in these regions. A more stringent response implemented in week 11, corresponding to 10 additional units on the 0-100 ordinal scale, was associated with 20 fewer weekly deaths (95% confidence interval 18 to 22) per million inhabitants.ConclusionsTravelling during winter holiday in week 9 was an amplifying event that contributed importantly to the excess mortality observed in the study area during the spring 2020. Timely government responses to the resulting early inflow of cases was associated with lower excess mortality.

Background Sweden has one of the highest numbers of COVID-19 deaths per inhabitant globally. However, absolute death counts can be misleading. Estimating age- and sex-specific mortality rates is necessary in order to account for the underlying population structure. Furthermore, given the difficulty of assigning causes of death, excess all-cause mortality should be estimated to assess the overall burden of the pandemic. Methods By estimating weekly age- and sex-specific death rates during 2020 and during the preceding 5 years, our aim is to get more accurate estimates of the excess mortality attributed to COVID-19 in Sweden, and in the most affected region Stockholm. Results Eight weeks after Sweden’s first confirmed case, the death rates at all ages above 60 were higher than for previous years. Persons above age 80 were disproportionally more affected, and men suffered greater excess mortality than women in ages up to 75 years. At older ages, the excess mortality was similar for men and women, with up to 1.5 times higher death rates for Sweden and up to 3 times higher for Stockholm. Life expectancy at age 50 declined by Conclusions The excess mortality has been high in older ages during the pandemic, but it remains to be answered if this is because of age itself being a prognostic factor or a proxy for comorbidity. Only monitoring deaths at a national level may hide the effect of the pandemic on the regional level.

Background Mortality doubles approximately every 6–7 years during adulthood. This exponential increase in death risk with chronological age is the population-level manifestation of ageing, and often referred to as the rate-of-ageing. Objective We explore whether the onset of severe chronic disease alters the rate-of-ageing. Methods Using Swedish register data covering the entire population of the birth cohorts 1927–30, we analyse whether being diagnosed with myocardial infarction, diabetes or cancer results in a deviation of the rate-of-ageing from those of the total population. We also quantify the long-term mortality effects of these diseases, using ages with equivalent mortality levels for those with disease and the total population. Results None of the diseases revealed a sustained effect on the rate-of-ageing. After an initial switch upwards in the level of mortality, the rate-of-ageing returned to the same pace as for the total population. The time it takes for the rate to return depends on the disease. The long-term effects of diabetes and myocardial infarction amount to mortality levels that are equivalent to those aged 5–7 years older in the total population. For cancer, the level of mortality returns to that of the total population. Conclusion Our results suggest an underlying process of ageing that causes mortality to increase at a set pace, with every year older we become. This process is not affected by disease history. The persistence of the rate-of-ageing motivates a critical discussion of what role disease prevention can play in altering the progression of ageing.

Life expectancy (LE) is considered a straightforward summary measure of mortality that comes with an implicit age standardisation. Thus, it has become common to present differences in mortality across populations as differences in LE, instead of, say, relative risks. However, most of the time LE does not quite provide what the term promises. LE is based on a synthetic cohort and is therefore not the true LE of anyone. Also, the implicit age standardisation is construed in such a way that it can be questioned whether it standardises age at all. In this paper, we examine LE from the point of view of its applicability to epidemiological and public health research and provide examples on the relation between an LE difference and a relative risk. We argue that the age standardisation in estimations of LE is not straightforward since it is standardised against different age distributions and that the translation of changes in age specific mortality into change in remaining LE will depend on the level and the distribution of mortality in the population. We conclude that LE is not the measure of choice in aetiological research or in research with the aim to identify risk factors of death, but that LE may be a compelling choice in public health contexts. One cannot escape the thought that the mathematical elegance of LE has contributed to its popularity.

Mortality from Covid-19 is monitored in detail and compared between countries with different strategies against the virus. There is, however, often a lack of understanding of what is required in terms of measures and interpretation to enable correct comparisons. The number of deaths from Covid-19 is affected by the testing strategy and many other things that differ between countries. Therefore, today, the most reliable source for monitoring and comparing mortality from Covid-19 is total mortality. In Sweden, there is good correspondence of Covid-19 deaths and total mortality, with a tendency to a higher total mortality indicating some under-reporting of Covid-19 mortality.

ObjectivesDescribe the burden and prevalence of prognostic factors of severe COVID-19 disease at national and county level in Sweden.DesignCross sectional studySettingSwedenParticipants9,624,428 individuals living in Sweden on 31st December 2014 and alive on 1st January 2016Main outcome measuresBurden and prevalence of prognostic factors for severe COVID-19 based on the guidelines from the World Health Organization and European Centre for Disease Prevention and Control, which are age 70 years and older, cardiovascular disease, cancer, chronic obstructive pulmonary disease, severe asthma, and diabetes. Prognostic factors were identified based on records for three years before 1st January 2016 from the Swedish National Inpatient and Outpatient Specialist Care Register, Prescribed Drug Register, and Cancer Register.Results22.1% of the study population had at least one prognostic factor for severe COVID-19 (2,131,319 individuals), and 1.6% had at least three factors (154,746 individuals). The prevalence of underlying medical conditions in the whole study population ranged from 0.8% with chronic obstructive pulmonary disease (78,516 individuals) to 7.4% with cardiovascular disease (708,090 individuals), and the county specific prevalence of at least one prognostic factor ranged from 19.2% in Stockholm (416,988 individuals) to 25.9% in Kalmar (60,005 individuals).ConclusionsThe prevalence of prognostic factors for severe COVID-19 disease will aid authorities in optimally planning healthcare resources during the ongoing pandemic. Results can also be applied to underlying assumptions of disease burden in modelling efforts to support COVID-19 planning. This information is crucial when deciding appropriate strategies to mitigate the pandemic and reduce both the direct mortality burden from the disease itself, and the indirect mortality burden from potentially overwhelmed health systems.

Background During the past decades, life expectancy has continued to increase in most high-income countries. Previous research suggests that improvements in life expectancy have primarily been driven by advances at the upper end of the health distribution, while parts of the population have lagged behind. Using data from the entire Swedish population, this study aims to examine the life expectancy development among subgroups of individuals with a history of common diseases relative to that of the general population. Methods The remaining life expectancy at age 65 was estimated for each year in 1998–2017 among individuals with a history of disease, and for the total Swedish population. We defined population subgroups as individuals with a history of myocardial infarction, ischemic or hemorrhagic stroke, hip fracture, or colon, breast, or lung cancer. We further distinguished between different educational levels and Charlson comorbidity index scores. Results Life expectancy gains have been larger for men and women with a history of myocardial infarction, ischemic or hemorrhagic stroke, and colon or breast cancer than for the general population. The life expectancy gap between individuals with a history of hip fracture or lung cancer and the general population has, however, been growing. Education and comorbidity have affected mortality levels, but have not altered the rate of increase in life expectancy among individuals with disease history. The female advantage in life expectancy was less pronounced among individuals with disease history than among the general population. Conclusions Life expectancy has increased faster in many subpopulations with a history of disease than in the general population, while still remaining at lower levels. Improvements in life expectancy have been observed regardless of comorbidity or educational level. These findings suggest that the rise in overall life expectancy reflects more than just improved survival among the healthy or the delayed onset of disease.

Highlights • Above median mobile phone call-time was associated with less sleep disturbance. • Above 90th percentile mobile phone call time was associated with insomnia. • Adjustment for network suggests association with insomnia was not due to RF-EMF. • Other potential explanations may be related to behavior and psychological factors., Background Effects of radiofrequency electromagnetic field exposure (RF-EMF) from mobile phone use on sleep quality has mainly been investigated in cross-sectional studies. The few previous prospective cohort studies found no or inconsistent associations, but had limited statistical power and short follow-up. In this large prospective cohort study, our aim was to estimate the effect of RF-EMF from mobile phone use on different sleep outcomes. Materials and methods The study included Swedish (n = 21,049) and Finnish (n = 3120) participants enrolled in the Cohort Study of Mobile Phone Use and Health (COSMOS) with information about operator-recorded mobile phone use at baseline and sleep outcomes both at baseline and at the 4-year follow-up. Sleep disturbance, sleep adequacy, daytime somnolence, sleep latency, and insomnia were assessed using the Medical Outcome Study (MOS) sleep questionnaire. Results Operator-recorded mobile phone use at baseline was not associated with most of the sleep outcomes. For insomnia, an odds ratio (OR) of 1.24, 95% CI 1.03–1.51 was observed in the highest decile of mobile phone call-time (>258 min/week). With weights assigned to call-time to account for the lower RF-EMF exposure from Universal Mobile Telecommunications Service (UMTS, 3G) than from Global System for Mobile Communications (GSM, 2G) the OR was 1.09 (95% CI 0.89–1.33) in the highest call-time decile. Conclusion Insomnia was slightly more common among mobile phone users in the highest call-time category, but adjustment for the considerably lower RF-EMF exposure from the UMTS than the GSM network suggests that this association is likely due to other factors associated with mobile phone use than RF-EMF. No association was observed for other sleep outcomes. In conclusion, findings from this study do not support the hypothesis that RF-EMF from mobile phone use has long-term effects on sleep quality.

Background: This ecological study of 219 regions in 11 European countries aimed to investigate the effect of the seemingly quasi-randomly assigned school winter holiday week on excess mortality associated with the COVID-19 pandemic during spring 2020. A secondary aim was to evaluate the impact of stringency and timing of the government responses to the early inflow of infected cases. Methods: Regional data on mortality week 14 – 23 in 2020 compared with the same period 2015 – 2019 were retrieved from Eurostat and national statistical agencies. Data on initial government responses were obtained from the Oxford COVID-19 Government Response Tracker. Variance-weighted least square regression was used to estimate the effect of winter holiday week and government responses with adjustment for population density and age distribution. Findings: Being a region with winter holiday exclusively in week 9 was in the adjusted analysis associated with 16 weekly excess deaths (95% CI 13 to 20) per million inhabitants, which corresponds to 38% of the excess mortality in these regions. A more stringent response implemented in week 11, corresponding to 10 additional units on the 0 – 100 ordinal scale, was associated with 20 fewer weekly deaths (95% CI 18 to 22) per million inhabitants. Interpretation: Winter holiday in week 9 was an amplifying event contributed importantly to the excess mortality observed in the study area during the spring 2020. Timely government response to the resulting early inflow of cases was associated with lower excess mortality. Funding: Swedish Research Council (Vetenskapsradet; grant no. 2019 – 00198). Declaration of Interests: The authors declare no conflicting interests. Ethics Approval Statement: The authors stated that this study was entirely based on aggregated data so no ethical approval was necessary.

Objective To assess excess mortality among suicide attempters compared to the general population. Method Remaining life expectancy was calculated for a nationwide cohort of all 187 894 persons 18 years or older hospitalised for the first time attempted suicide in Sweden in 1971–2010. Results Life expectancy was shortened throughout the lifespan for both men and women debuting with suicide attempt. The reduction in life expectancy for men debuting with a suicide attempt at 20 years of age was 18 years while the reduction for men debuting at 50 years of age was 10 years. For women attempting suicide, the life expectancy was shortened by 11 and 8 years respectively. The gender difference in life expectancy attenuated in patients making their first suicide attempt at age 70 years or older. Suicide deaths explained about 20% of the total mortality within 10 years of the suicide attempt and 5% in those with duration of four decades since the first suicide attempt. Conclusion The life expectancy is dramatically reduced in patients attempting suicide. With most excess deaths being due to physical health conditions, public efforts should be directed both towards improving physical health and to prevent suicide.

Background Both age and comorbidity are established risk factors for death among those infected with COVID-19. Because they often co-exist, it is difficult to assess if age is a risk factor on its own. Methods We used administrative register data of the total Swedish population from 01/2015 until 07/2020. We stratified the population aged 70+ into three groups according to level of care (in care homes, with home care, and in independent living). Within these groups, we explored the level of excess mortality in 2020 by estimating expected mortality with Poisson regression and compared it to observed levels. We investigated if excess mortality has been of the same magnitude in the three groups, and if age constitutes a risk factor for death during the pandemic regardless of level of care. Findings Individuals living in care homes experienced the highest excess mortality (75- >100% in April, 25–50% in May, 0–25% in June, depending on age). Individuals with home care showed the second highest magnitude (30–60% in April, 15–40% in May, 0–25% in June), while individuals in independent living experienced excess primarily at the highest ages (5–50% in April, 5–50% in May, 0–25% in June). Although mortality rates increased, the age-pattern of mortality during the pandemic resembled the age-pattern observed in previous years. Interpretation We found stepwise elevated excess mortality by level of care during the first wave of the COVID-19 pandemic in Sweden, suggesting that level of frailty or comorbidities plays a more important role than age for COVID-19 associated deaths. Part of our findings are likely attributable to differences in exposure to the virus between individuals receiving formal care and those living independently, and not only different case fatality between the groups. Although age is a strong predictor for mortality, the relative effect of age on mortality was no different during the pandemic than before. We believe this is an important contribution to the discussion of the pandemic, its consequences, and which groups need the most protection. Funding This study was funded by the Swedish Research Council for Health, Working Life and Welfare (FORTE: grant 2016-07115).

Aim: To illustrate how the fundamental epidemiological measures, incidence rate and prevalence proportion, can be estimated based on Swedish population registers using acute myocardial infarction (MI) as an example, together with a discussion about the analytical decisions. Methods: All individuals in Sweden aged 60–89 (born 1904–1954) during the study period 1994–2014 were identified through the Total Population Register. Cases of MI were defined and identified from information on hospital admissions and causes of death. Incidence rates of all, first, and recurrent MI were calculated together with prevalence proportions. Results: The incidence rate of all, first, and recurrent MI declined over the study period. While the incidence rates of first MI are lower for women than men, the incidence rates of recurrent MI are considerably higher but similar for men and women. The prevalence calculated with duration of disease set at 28 days also declined. This was despite improved survival from MI and increased life expectancy over the same period meaning that the decline in incidence was large enough to compensate for increased survival. Conclusions: Calculating incidence and prevalence of diseases using population registers requires detailed and well-reasoned definitions. The definitions will affect both the study population and the number of disease events and it is essential that the cases and the study population are defined in a coherent way. Different measures of disease occurrence contribute with different aspects of the disease panorama and a joint interpretation contributes to a thorough understanding of the disease development in a population.

Background: While studies have consistently found an association between childhood leukemia risk and magnetic fields, the associations between childhood leukemia and distance to overhead power lines have been inconsistent. We pooled data from multiple studies to assess the association with distance and evaluate whether it is due to magnetic fields or other factors associated with distance from lines. Methods: We present a pooled analysis combining individual-level data (29,049 cases and 68,231 controls) from 11 record-based studies. Results: There was no material association between childhood leukemia and distance to nearest overhead power line of any voltage. Among children living In this first comprehensive pooled analysis of childhood leukemia and distance to power lines, we found a small and imprecise risk for residences

Background/Aim: Possible health effects of mobile phone use are of considerable public and scientific interest, but previous epidemiological research has been limited by problems associated with (d...

Increasing longevity can distort time trends in summary measures of health and mortality, such as the lifetime risk of getting diseased. If not observing a cohort, this lifetime risk is calculated with cross-sectional data on age-specific incidence and survival. In those instances, incidence and survival may work in opposite directions resulting in lifetime risk estimates where, reductions in incidence might be offset by a simultaneous longevity increase. The proposed method decomposes the difference between two lifetime risks into contributions of changing incidence and changing survival. The approach can be extended to measure the contributions of changes in disease related mortality and even case fatality. We illustrate the method with hypothetical examples as well as remaining lifetime risk at age 60 of experiencing a myocardial infarction, colorectal cancer and hip fractures for Swedish males. The empirical examples show that the influence of increasing longevity on the development of lifetime risk depends on the respective age profile of occurrence. In the cases of myocardial infarction and hip fracture, longevity increases of the general population counterbalanced or even exceeded the substantial gains in disease incidence, while for colorectal cancer, the lifetime risk was almost unaffected by the longevity improvement. This was because colorectal cancer has an on average earlier onset than myocardial infarction and hip fracture.

Background Hip fracture is a common cause of disability and mortality among the elderly. Declining incidence trends have been observed in Sweden. Still, this condition remains a significant public health problem since Sweden has one of the highest incidences worldwide. Yet, no Swedish lifetime risk or survival trends have been presented. By examining how hip fracture incidence, post-fracture survival, as well as lifetime risk have developed between 1995 and 2010 in Sweden, this study aims to establish how the burden hip fractures pose on the elderly changed over time, in order to inform initiatives for improvements of their health. Material and Methods The entire Swedish population 60 years-old and above was followed between 1987 and 2010 in the National Patient Register and the Cause of Death Register. Annual age-specific hip fracture cumulative incidence was estimated using hospital admissions for hip fractures. Three-month and one-year survival after the first hip fracture were also estimated. Period life table was used to assess lifetime risk of hip fractures occurring from age 60 and above, and the expected mean age of the first hip fracture. Results The age-specific hip fracture incidence decreased between 1995 and 2010 in all ages up to 94 years, on average by 1% per year. The lifetime risk remained almost stable, between 9% and 11% for men, and between 18% and 20% for women. The expected mean age of a first hip fracture increased by 2.5 years for men and by 2.2 years for women. No improvements over time were observed for the 3-month survival for men, while for women a 1% decrease per year was observed. The 1-year survival slightly increased over time for men (0.4% per year) while no improvement was observed for women. Conclusions The age-specific hip fracture incidence has decreased over time. Yet the lifetime risk of a hip fracture has not decreased because life expectancy in the population has increased in parallel. Overall, survival after hip fracture has not improved.