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

Journal article
Authors Lena Johansson
Hilda K Svensson
Jón Karlsson
Lars-Eric Olsson
Dan Mellström
Mattias Lorentzon
Daniel Sundh
Published in Osteoporosis International
Volume 30
Issue 10
Pages 1961–1971
ISSN 0937-941X
Publication year 2019
Published at University of Gothenburg Centre for person-centred care (GPCC)
Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Institute of Health and Care Sciences
Institute of Clinical Sciences
Pages 1961–1971
Language en
Keywords HRQoL, Older women, Vertebral fractures, VFA
Subject categories Geriatrics


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. © 2019, The Author(s).

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