title: The influence of osteoporotic fractures on health-related quality of life in community-dwelling men and women across Canada.
abstract: Health-related quality of life (HRQL) was examined in relation to prevalent fractures in 4816 community-dwelling Canadian men and women 50 years and older participating in the Canadian Multicentre Osteoporosis Study (CaMos). Fractures were of three categories: clinically recognized main fractures, subclinical vertebral fractures and fractures at other sites. Main fractures were divided and analyzed at the hip, spine, wrist/forearm, pelvis and rib sites. Baseline assessments of anthropometric data, medical history, therapeutic drug use, spinal radiographs and prevalent fractures were obtained from all participants. The SF-36 instrument was used as a tool to measure HRQL. A total of 652 (13.5%) main fractures were reported. Results indicated that hip, spine, wrist/forearm, pelvis and rib fractures had occurred in 78 (1.6%), 40 (0.8%), 390 (8.1%), 19 (0.4%) and 125 (2.6%) individuals, respectively (subjects may have had more than one main fracture). Subjects who had experienced a main prevalent fracture had lower HRQL scores compared with non-fractured participants. The largest differences were observed in the physical functioning (-4.0; 95% confidence intervals (CI): -6.0, -2.0) and role-physical functioning domains (-5.8; 95% CI: -9.5, -2.2). In women, the physical functioning domain was most influenced by hip (-14.9%; 95% CI: -20.9, -9.0) and pelvis (-18.1; 95% CI: -27.6, -8.6) fractures. In men, the role-physical domain was most affected by hip fractures (-35.7; 95% CI: -60.4, -11.1). Subjects who experienced subclinical vertebral fractures had lower HRQL scores than those without prevalent fractures. In conclusion, HRQL was lower in the physical functioning domain in women and the role-physical domain in men who sustained main fractures at the hip. Subclinical vertebral fractures exerted a moderate effect on HRQL.
authors.affiliation: Department of Medicine, St Joseph's Hospital, McMaster University, Hamilton, Ontario Canada.
authors.forename: J D
authors.initials: JD
authors.lastname: Adachi
authors.forename: G
authors.initials: G
authors.lastname: Loannidis
authors.forename: C
authors.initials: C
authors.lastname: Berger
authors.forename: L
authors.initials: L
authors.lastname: Joseph
authors.forename: A
authors.initials: A
authors.lastname: Papaioannou
authors.forename: L
authors.initials: L
authors.lastname: Pickard
authors.forename: E A
authors.initials: EA
authors.lastname: Papadimitropoulos
authors.forename: W
authors.initials: W
authors.lastname: Hopman
authors.forename: S
authors.initials: S
authors.lastname: Poliquin
authors.forename: J C
authors.initials: JC
authors.lastname: Prior
authors.forename: D A
authors.initials: DA
authors.lastname: Hanley
authors.forename: W P
authors.initials: WP
authors.lastname: Olszynski
authors.forename: T
authors.initials: T
authors.lastname: Anastassiades
authors.forename: J P
authors.initials: JP
authors.lastname: Brown
authors.forename: T
authors.initials: T
authors.lastname: Murray
authors.forename: S A
authors.initials: SA
authors.lastname: Jackson
authors.forename: A
authors.initials: A
authors.lastname: Tenenhouse
mesh_terms: D000368:Aged; D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D050723:Fractures, Bone / Q000209:etiology*; D006304:Health Status; D006620:Hip Fractures / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000150:complications*; D010384:Pelvic Bones / Q000293:injuries; D011788:Quality of Life; D012044:Regression Analysis; D012253:Rib Fractures / Q000209:etiology; D016103:Spinal Fractures / Q000209:etiology; D014954:Wrist Injuries / Q000209:etiology