title: Bone health and deterioration in quality of life among participants from the Hertfordshire cohort study.
abstract: 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).
authors.affiliation: MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK. emd@mrc.soton.ac.uk
authors.forename: E M
authors.initials: EM
authors.lastname: Dennison
authors.forename: K A
authors.initials: KA
authors.lastname: Jameson
authors.forename: H E
authors.initials: HE
authors.lastname: Syddall
authors.forename: H J
authors.initials: HJ
authors.lastname: Martin
authors.forename: J
authors.initials: J
authors.lastname: Cushnaghan
authors.forename: A
authors.initials: A
authors.lastname: Aihie Sayer
authors.forename: C
authors.initials: C
authors.lastname: Cooper
mesh_terms: 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