Impact of prevalent fractures on quality of life: baseline results from the global longitudinal study of osteoporosis in women
AuthorsAdachi, Jonathan D.
Gehlbach, Stephen H.
Anderson, Frederick A. Jr.
Chapurlat, Roland D.
Compston, Juliet E.
Greenspan, Susan L.
Hooven, Frederick H.
LaCroix, Andrea Z.
Netelenbos, J. Coen
Saag, Kenneth G.
Siris, Ethel S.
Watts, Nelson B.
UMass Chan AffiliationsCenter for Outcomes Research
Document TypeJournal Article
KeywordsAge Factors; Aged; Europe; Female; Femoral Fractures; Fractures, Bone; Health Status; Hip Fractures; Humans; Linear Models; Longitudinal Studies; Middle Aged; Osteoporosis; *Quality of Life; Spinal Fractures
Health Services Research
Mental and Social Health
Nutritional and Metabolic Diseases
MetadataShow full item record
AbstractOBJECTIVE: To examine several dimensions of health-related quality of life (HRQL) in postmenopausal women who report previous fractures, and to provide perspective by comparing these findings with those in other chronic conditions (diabetes, arthritis, lung disease). PATIENTS AND METHODS: Fractures are a major cause of morbidity among older women. Few studies have examined HRQL in women who have had prior fractures and the effect of prior fracture location on HRQL. In this observational study of 57,141 postmenopausal women aged 55 years and older (enrollment from December 2007 to March 2009) from 17 study sites in 10 countries, HRQL was measured using the European Quality of Life 5 Dimensions Index (EQ-5D) and the health status, physical function, and vitality questions of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). RESULTS: Reductions in EQ-5D health-utility scores and SF-36-measured health status, physical function, and vitality were seen in association with 9 of 10 fracture locations. Spine, hip, and upper leg fractures resulted in the greatest reductions in quality of life (EQ-5D scores, 0.62, 0.64, and 0.61, respectively, vs 0.79 without prior fracture). Women with fractures at any of these 3 locations, as well as women with a history of multiple fractures (EQ-5D scores, 0.74 for 1 prior fracture, 0.68 for 2, and 0.58 for >/=3), had reductions in HRQL that were similar to or worse than those in women with other chronic diseases (0.67 for diabetes, 0.69 for arthritis, and 0.71 for lung disease). CONCLUSION: Previous fractures at a variety of bone locations, particularly spine, hip, and upper leg, or involving more than 1 location are associated with significant reductions in quality of life.
Mayo Clin Proc. 2010 Sep;85(9):806-13. Epub 2010 Jul 15. Link to article on publisher's site
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/27162
RightsThis article is freely available on publication, because the authors have chosen the immediate access option.
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Inhibitors of hydroxymethylglutaryl-coenzyme A reductase and risk of fracture among older womenChan, K. Arnold; Andrade, Susan E.; Boles, Myde; Buist, Diana S. M.; Chase, Gary A.; Donahue, James G.; Goodman, Michael J.; Gurwitz, Jerry H.; LaCroix, Andrea Z.; Platt, Richard (2000-07-06)BACKGROUND: Inhibitors of hydroxymethylglutaryl-coenzyme A reductase (statins) increase new bone formation in rodents and in human cells in vitro. Statin use is associated with increased bone mineral density of the femoral neck. We undertook a population-based case-control study at six health-maintenance organisations in the USA to investigate further the relation between statin use and fracture risk among older women. METHODS: We investigated women aged 60 years or older. Exposure, outcome, and confounder information was obtained from automated claims and pharmacy data from October, 1994, to September, 1997. Cases had an incident diagnosis of non-pathological fracture of the hip, humerus, distal tibia, wrist, or vertebrae between October, 1996, and September, 1997. Controls had no fracture during this period. We excluded women with records of dispensing of drugs to treat osteoporosis. FINDINGS: There were 928 cases and 2747 controls. Compared with women who had no record of statin dispensing during the previous 2 years, women with 13 or more statin dispensings during this period had a decreased risk of non-pathological fracture (odds ratio 0.48 [95% CI 0.27-0.83]) after adjustment for age, number of hospital admissions during the previous year, chronic disease score, and use of non-statin lipid-lowering drugs. No association was found between fracture risk and fewer than 13 dispensings of statins or between fracture risk and use of non-statin lipid-lowering drugs. INTERPRETATION: Statins seem to be protective against non-pathological fracture among older women. These findings are compatible with the hypothesis that statins increase bone mineral density in human beings and thereby decrease the risk of osteoporotic fractures.
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