title: Health-related quality of life in women referred for bone density assessment: relationships with bone mineral density, fracture and co-morbidity.
abstract: OBJECTIVE
  To identify variables that might influence health-related quality of life (HRQoL) in patients with and without a history of fracture, attending bone mineral density (BMD) assessment prior to diagnosis of osteoporosis.
  
  
  METHODS
  This cross-sectional study included 312 newly referred postmenopausal women attending for a DXA scan, without a diagnosis of osteoporosis. Data were obtained from the medical history and the General Practitioner's letter. HRQoL, using SF36 was scored using published algorithms with reference to an age-related population from England. Regression analyses were used to determine relationships between HRQoL and BMD, age, fracture status and co-morbidities.
  
  
  RESULTS
  For all patients, the age-related physical component summary (PCS) and mental component summary (MCS) scores were 46 ± 10 and 47 ± 10, respectively. Controlling for confounding variables, low BMD at the femoral neck was associated with worse PCS scores (p = 0.010) and MCS scores (p = 0.034) in patients without fracture. In patients with a history of fracture, this relationship was less evident, and younger age (p < 0.00), increasing BMI (p = 0.016) and number of co-morbidities (p = 0.042) were associated with reductions in PCS scores.
  
  
  CONCLUSIONS
  Patients referred for BMD assessment before a diagnosis of osteoporosis had reduced PCS scores. In patients without fracture, low BMD contributed to this reduction in health-related quality of life. Low PCS scores in patients with fracture were seen only in younger subjects with osteoporosis.
authors.affiliation: School of Sport Health and Exercise Sciences, Bangor University, George Building, Holyhead Road, Bangor, Gwynedd, LL57 2PZ, UK, sally.wilson@bangor.ac.uk.
authors.forename: Sally
authors.initials: S
authors.lastname: Wilson
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Sharp
authors.forename: Michael W J
authors.initials: MW
authors.lastname: Davie
mesh_terms: D000368:Aged; D015519:Bone Density; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000523:psychology*; D017698:Postmenopause; D011788:Quality of Life; D011859:Radiography; D011795:Surveys and Questionnaires