title: Impact of prevalent fractures on quality of life: baseline results from the global longitudinal study of osteoporosis in women.
abstract: OBJECTIVE
  To examine several dimensions of health-related quality of life (HRQL) in postmenopausal women who report previous fractures, and to provide perspective by comparing these findings with those in other chronic conditions (diabetes, arthritis, lung disease).
  
  
  METHODS
  Fractures are a major cause of morbidity among older women. Few studies have examined HRQL in women who have had prior fractures and the effect of prior fracture location on HRQL. In this observational study of 57,141 postmenopausal women aged 55 years and older (enrollment from December 2007 to March 2009) from 17 study sites in 10 countries, HRQL was measured using the European Quality of Life 5 Dimensions Index (EQ-5D) and the health status, physical function, and vitality questions of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36).
  
  
  RESULTS
  Reductions in EQ-5D health-utility scores and SF-36-measured health status, physical function, and vitality were seen in association with 9 of 10 fracture locations. Spine, hip, and upper leg fractures resulted in the greatest reductions in quality of life (EQ-5D scores, 0.62, 0.64, and 0.61, respectively, vs 0.79 without prior fracture). Women with fractures at any of these 3 locations, as well as women with a history of multiple fractures (EQ-5D scores, 0.74 for 1 prior fracture, 0.68 for 2, and 0.58 for >/=3), had reductions in HRQL that were similar to or worse than those in women with other chronic diseases (0.67 for diabetes, 0.69 for arthritis, and 0.71 for lung disease).
  
  
  CONCLUSIONS
  Previous fractures at a variety of bone locations, particularly spine, hip, and upper leg, or involving more than 1 location are associated with significant reductions in quality of life.
authors.affiliation: St. Joseph's Hospital, McMaster University, 501-25 Charlton Ave E, Hamilton, Ontario, L8N 1Y2, Canada. jd.adachi@sympatico.ca
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Adachi
authors.forename: Silvano
authors.initials: S
authors.lastname: Adami
authors.forename: Stephen
authors.initials: S
authors.lastname: Gehlbach
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Anderson
authors.forename: Steven
authors.initials: S
authors.lastname: Boonen
authors.forename: Roland D
authors.initials: RD
authors.lastname: Chapurlat
authors.forename: Juliet E
authors.initials: JE
authors.lastname: Compston
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
authors.forename: Pierre
authors.initials: P
authors.lastname: Delmas
authors.forename: Adolfo
authors.initials: A
authors.lastname: Díez-Pérez
authors.forename: Susan L
authors.initials: SL
authors.lastname: Greenspan
authors.forename: Frederick H
authors.initials: FH
authors.lastname: Hooven
authors.forename: Andrea Z
authors.initials: AZ
authors.lastname: LaCroix
authors.forename: Robert
authors.initials: R
authors.lastname: Lindsay
authors.forename: J Coen
authors.initials: JC
authors.lastname: Netelenbos
authors.forename: Olivia
authors.initials: O
authors.lastname: Wu
authors.forename: Johannes
authors.initials: J
authors.lastname: Pfeilschifter
authors.forename: Christian
authors.initials: C
authors.lastname: Roux
authors.forename: Kenneth G
authors.initials: KG
authors.lastname: Saag
authors.forename: Philip N
authors.initials: PN
authors.lastname: Sambrook
authors.forename: Stuart
authors.initials: S
authors.lastname: Silverman
authors.forename: Ethel S
authors.initials: ES
authors.lastname: Siris
authors.forename: Grigor
authors.initials: G
authors.lastname: Nika
authors.forename: Nelson B
authors.initials: NB
authors.lastname: Watts
mesh_terms: D000367:Age Factors; D000368:Aged; D005060:Europe; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000523:psychology; D050723:Fractures, Bone / Q000209:etiology / Q000523:psychology*; D006304:Health Status; D006620:Hip Fractures / Q000209:etiology / Q000523:psychology; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000523:psychology; D011788:Quality of Life; D016103:Spinal Fractures / Q000209:etiology / Q000523:psychology