Bone health and deterioration in quality of life among participants from the Hertfordshire cohort study.
We utilised the Hertfordshire cohort study to examine relationships between bone density at baseline and SF-36 status 4 years later. We found deterioration in the mental health domain over follow-up in osteoporotic men (but not women) compared with other groups (relative rate ratio=5.78, 95% confidence interval (CI) 1.78-19.2).


BACKGROUND
Osteoporosis is associated with decreased quality of life, although it has been difficult to evaluate the confounding effects of fracture and co-morbidity. Having previously shown that male osteoporotics have poorer health than counterparts with normal bone mineral density, even after adjustment for co-morbidity and prior fracture, we assessed quality of life in both groups 4 years apart.


METHODS
Four hundred and ninety-eight men and 468 women completed questionnaires detailing lifestyle factors, co-morbidities and quality of life (SF-36) before undergoing bone density measurements at the lumbar spine and total femur. At follow-up 4 years later, 322 men and 320 women were reassessed.


RESULTS
Multinomial logistic regression confirmed deterioration in mental health over follow-up in osteoporotic men compared with other groups (relative rate ratio=5.78, 95% CI 1.78-19.2). These patterns were not apparent among women.


CONCLUSIONS
Men with lower bone density at baseline had poorer quality of life some 4 years later, even after adjustment for co-morbidity and fracture. This may reflect secondary osteoporosis in men (due to alcohol or hypogonadism).
Dennison
E M
EM
MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK. emd@mrc.soton.ac.uk
Jameson
K A
KA
Syddall
H E
HE
Martin
H J
HJ
Cushnaghan
J
J
Aihie Sayer
A
A
Cooper
C
C
D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D015519:Bone Density / Q000502:physiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005269:Femur / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D001523:Mental Disorders / Q000209:etiology; D008875:Middle Aged; D010024:Osteoporosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D011594:Psychometrics; D011788:Quality of Life