title: The impact of asymptomatic vertebral fractures on quality of life in older community-dwelling women: the São Paulo Ageing & Health Study.
abstract: OBJECTIVE
  The aim of this study was to investigate the impact of asymptomatic vertebral fractures on the quality of life in older women as part of the Sao Paulo Ageing & Health Study.
  
  
  METHODS
  This study was a cross-sectional study with a random sample of 180 women 65 years of age or older with or without vertebral fractures. The Quality of Life Questionnaire of the European Foundation for Osteoporosis was administered to all subjects. Anthropometric data were obtained by physical examination, and the body mass index was calculated. Lateral thoracic and lumbar spine X-ray scans were obtained to identify asymptomatic vertebral fractures using a semi-quantitative method.
  
  
  RESULTS
  Women with asymptomatic vertebral fractures had lower total scores [61.4(15.3) vs. 67.1(14.2), p = 0.03] and worse physical function domain scores [69.5(20.1) vs. 77.3(17.1), p = 0.02] for the Quality of Life Questionnaire of the European Foundation for Osteoporosis compared with women without fractures. The total score of this questionnaire was also worse in women classified as obese than in women classified as overweight or normal. High physical activity was related to a better total score for this questionnaire (p = 0.01). Likewise, lower physical function scores were observed in women with higher body mass index values (p<0.05) and lower physical activity levels (p<0.05). Generalized linear models with gamma distributions and logarithmic link functions, adjusted for age, showed that lower total scores and physical function domain scores for the Quality of Life Questionnaire of the European Foundation for Osteoporosis were related to a high body mass index, lower physical activity, and the presence of vertebral fractures (p<0.05).
  
  
  CONCLUSIONS
  Vertebral fractures are associated with decreased quality of life mainly physical functioning in older community-dwelling women regardless of age, body mass index, and physical activity. Therefore, the results highlight the importance of preventing and controlling asymptomatic vertebral fractures to reduce their impact on quality of life among older women.
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Disciplina de Reumatologia, São Paulo/SP, Brazil.
authors.forename: Jaqueline B
authors.initials: JB
authors.lastname: Lopes
authors.forename: Leandro K
authors.initials: LK
authors.lastname: Fung
authors.forename: Caroline C
authors.initials: CC
authors.lastname: Cha
authors.forename: Gustavo M
authors.initials: GM
authors.lastname: Gabriel
authors.forename: Liliam
authors.initials: L
authors.lastname: Takayama
authors.forename: Camille P
authors.initials: CP
authors.lastname: Figueiredo
authors.forename: Rosa Maria R
authors.initials: RM
authors.lastname: Pereira
mesh_terms: D000368:Aged; D058070:Asymptomatic Diseases; D015992:Body Mass Index; D004812:Epidemiologic Methods; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D009043:Motor Activity / Q000502:physiology*; D011788:Quality of Life; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*