Decreased physical health-related quality of life—a persisting state for older women with clinical vertebral fracture

• Published in: Osteoporosis international Vol. 30; no. 10; pp. 1961 - 1971
• Main Authors: Johansson, L., Svensson, H. K., Karlsson, J., Olsson, L.-E., Mellström, D., Lorentzon, M., Sundh, D.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.10.2019; Springer Nature B.V
• Subjects: Absorptiometry, Photon; Aged; Aged, 80 and over; Anthropometry - methods; Bone Density - physiology; Bone mineral density; Cross-Sectional Studies; Dual energy X-ray absorptiometry; Endocrinology; Exercise - physiology; Female; Fractures; Geriatrics; Geriatrik; Health risk assessment; Hip; Hip Fractures - epidemiology; Hip Fractures - physiopathology; Hip Fractures - rehabilitation; HRQoL; Humans; Lumbar Vertebrae - physiopathology; Medicine; Medicine & Public Health; Older people; Older women; Original; Original Article; Orthopedics; Osteoporotic Fractures - diagnostic imaging; Osteoporotic Fractures - epidemiology; Osteoporotic Fractures - physiopathology; Osteoporotic Fractures - rehabilitation; Pain; Physical activity; Physical Fitness - physiology; Population studies; Psychometrics; Quality of Life; Registries; Rheumatology; Self Report; Smoking; Spinal Fractures - diagnostic imaging; Spinal Fractures - epidemiology; Spinal Fractures - physiopathology; Spinal Fractures - rehabilitation; Spine (lumbar); Sweden - epidemiology; Time Factors; Vertebrae; Vertebral fractures; VFA; Sweden; VFA; Older women; HRQoL; Vertebral fractures
• ISSN: 0937-941X; 1433-2965; 1433-2965
• DOI: 10.1007/s00198-019-05044-0

Summary In a population-based study of older Swedish women, we investigated if clinical vertebral fracture was associated with lower health-related quality of life (HRQoL) and determined whether the association remained over time. Clinical vertebral fracture was associated with lower HRQoL and the effect persisted for up to 18.9 years. Introduction Vertebral fractures are often associated with back pain and reduced physical function, which might result in isolation and depression. As a result, women with vertebral fractures often have lower health-related quality of life (HRQoL), but during what time frame the decrease lingers is unclear. Therefore, the aim of this study was to investigate if clinical vertebral fracture and hip fracture were associated with lower HRQoL and to determine whether the associations remained over time. Methods Vertebral fracture assessments (VFA) were performed using dual-energy X-ray absorptiometry. Data regarding prior fractures, medications, medical history, and physical activity was collected using a questionnaire. Self-rated physical HRQoL was assessed using the 12-Item Short-Form Health Survey (SF-12). Women with clinical vertebral fractures were divided into tertiles according to time since fracture onset and their HRQoL was compared with non-fractured women. Results In a population-based cross-sectional study of 3028 women aged 77.8 ± 1.63 (mean ± SD), a total of 130 (4.3%) women reported at least one clinical vertebral fracture. Women with a clinical vertebral fracture, divided into tertiles (T1–T3) depending on time since the fracture occurred, had lower HRQoL (T1: 36.3 ± 10.8; T2: 41.0 ± 9.94; and T3:41.6 ± 11.4) than women without fracture (46.2 ± 10.6; p  < 0.001). Using linear regression analysis, clinical vertebral fracture was associated with reduced physical HRQoL for up to 18.9 years, independently of covariates (age, height, weight, smoking, prior stroke, mental HRQoL, grip strength, and lumbar spine BMD). Conclusions Clinical vertebral fracture was associated with lower self-rated physical HRQoL, for up to 18.9 years after time of fracture.