Incident Fragility Fractures Have a Long-Term Negative Impact on Health-Related Quality of Life of Older People: The Canadian Multicentre Osteoporosis Study

Abstract

Although the short‐term impact of incident fragility fractures on health‐related quality of life (HRQL) of older people has been confirmed, we lack long‐term evidence. We explored the impact of incident fragility fractures on HRQL, among people aged 50 years and older, using 10‐year prospective data from the Canadian Multicentre Osteoporosis Study (CaMos). This study was based on data from 7753 (2187 men and 5566 women) participants of CaMos. The HRQL, measured through the Health Utility Index (HUI), was captured at baseline and year 10. The incident fragility fractures were recorded over 10 years of follow‐up at spine, hip, rib, shoulder, pelvis, or forearm. Multivariable regression analysis was conducted to measure the mean difference, termed as deficit, in the HUI scores for participants with and without fractures. We examined the effects of single or multiple fragility fractures, time (fractures that occurred between year 1 to 5 and 6 to 10) and recovery to the prefracture level. Incident spine and hip fractures were associated with significant deficits (varied from –0.19 to –0.07) on the HUI scores. Hip and spine fractures were associated with negative impact on mobility, self‐care, and ambulation. Fractures that occurred closer to the follow‐up assessment were associated with significant impact on HRQL compared to fractures occurring a long time before it, except for hip fracture (deficits lasted 5 years or longer). Similarly, multiple hip (–0.14), spine (–0.16), and rib (–0.21) fractures significantly impacted the HRQL of women. Women with a hip fracture never recovered to their prefracture level score (OR = 0.41; 95% confidence interval [CI], 0.19 to 0.98). Our analysis suggests that single and multiple hip fractures as well as multiple spine and rib fractures strongly impact the HRQL of older people over a prolonged period of time. © 2019 American Society for Bone and Mineral Research.

Quality of life after fragility fracture in the Russian Federation: results from the Russian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (ICUROS)

“…For all these reasons, between-center and between-country differences in HSUVs are difficult to interpret. Notwithstanding, a persistent disutility at 18 months is a consistent finding for hip [28][29][30] and spine fractures [8,31]. Conversely, there is general agreement that the disutility following fracture of the distal forearm is transient [32,33].…”

Systemic Adeno-Associated Virus-Mediated Gene Therapy Prevents the Multiorgan Disorders Associated with Aldehyde Dehydrogenase 2 Deficiency and Chronic Ethanol Ingestion

“…Osteoporosis caused by chronic alcohol consumption is detrimental to quality of life and a significant financial burden on both individuals and society. 76,77 Worldwide, 67 million individuals >50 years old with ALDH2 deficiency are at increased risk for osteoporosis with chronic alcohol intake. 2,3,[78][79][80] Alcoholism is a risk factor for osteoporosis even in individuals without ALDH2 deficiency.…”

A Risk Assessment Tool for Predicting Fragility Fractures and Mortality in the Elderly

“…F ragility fractures impose a significant public health problem globally as they are highly prevalent (1,2) and are associated with significant morbidity and mortality (3)(4)(5)(6) and substantial economic burden. (7) From the age of 50 years, approximately 16% and 32% of women in the United States will experience a hip or clinical vertebral fracture, respectively, compared with a 9% lifetime risk of developing breast cancer and 3% risk of developing endometrial cancer.…”

“…(4,8) In addition to mortality, survivors after an initial fracture also have an increased risk of subsequent fracture, (5) increased dependence, and reduced quality of life. (6) It is thus critical to identify individualized risk of both fragility fracture and its related consequences to be able to make meaningful decisions about appropriate interventions to prevent not only the first fracture but also the deleterious consequences triggered by the first fracture.…”