Multimorbidity is associated with fragility fractures in women 50 years and older: A nationwide cross-sectional study

Barcelos, Anabela; Lopes, David G.; Canhão, Helena; Branco, Jaime

doi:10.1016/j.bonr.2021.101139

Cited by 12 publications

(12 citation statements)

References 32 publications

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“…This falls in the upper range or exceeds the reported prevalence of polypharmacy and multimorbidity in adults aged 65 years and older in the United States, which range from 39% to 46.6% and 67% to 91.8%, respectively 18–21 . Similarly, in all-female adult cohorts, prevalence of polypharmacy ranges from 28% to 36% and multimorbidity prevalence ranges from 49.7% to 67.3%, although notably these studies were conducted outside of the United States and may not be representative of American women 22–25 . The higher rates of polypharmacy and multimorbidity that we document may be due to our cohort being all-female, diverse, and derived from an urban population with a greater likelihood of patients of lower socioeconomic status.…”

Section: Discussionmentioning

confidence: 73%

“…[18][19][20][21] Similarly, in all-female adult cohorts, prevalence of polypharmacy ranges from 28% to 36% and multimorbidity prevalence ranges from 49.7% to 67.3%, although notably these studies were conducted outside of the United States and may not be representative of American women. [22][23][24][25] The higher rates of polypharmacy and multimorbidity that we document may be due to our cohort being all-female, diverse, and derived from an urban population with a greater likelihood of patients of lower socioeconomic status. Existing literature shows an increased rate of multimorbidity in females, non-Hispanic Blacks, and Whites, and individuals with household incomes less than 100,000.…”

Section: Discussionmentioning

confidence: 84%

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Polypharmacy and Multimorbidity in the Urogynecology Population and Their Effect on Pelvic Floor Symptoms

Zuo

Tellechea

Kohn

et al. 2022

UROGC

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ImportancePolypharmacy and multimorbidity are common in older adults but has not been well studied in the urogynecologic patient population.ObjectivesThe objective of this study was to determine the prevalence of polypharmacy and multimorbidity in a diverse outpatient urogynecologic population and to examine whether polypharmacy and/or multimorbidity were associated with lower urinary tract symptoms, pelvic organ prolapse, defecatory distress, and/or female sexual dysfunction.Study DesignThis is a secondary analysis of a dual-center cross-sectional study of new patients presenting for evaluation of pelvic floor disorders at 2 urban academic outpatient urogynecology clinics. Baseline demographics and clinical characteristics were obtained from the electronic medical record. Validated surveys were administered to determine severity of lower urinary tract symptoms (Overactive Bladder Validated 8-Question Screener, Urogenital Distress Inventory-6), pelvic floor dysfunction (Pelvic Organ Prolapse Distress Inventory-6, Colorectal-Anal Distress Inventory-8), and sexual dysfunction (6-item Female Sexual Function Index). Standard statistical techniques were used.ResultsOne hundred ninety-seven women with mean age 58.8 years (SD, 13.4 years) were included, and most were of minority race/ethnicity (Black, 34.0%; Hispanic, 21.8%). The majority of participants met criteria for polypharmacy (58.4%) and multimorbidity (85.8%), with a mean prescription number of 6.5 (SD, ± 4.9) and mean number of medical comorbidities of 4.9 (SD, ± 3.3). Polypharmacy and multimorbidity were significantly associated with higher CRADI-8 scores. Specifically, polypharmacy was associated with straining with bowel movements and painful stools, whereas multimorbidity was associated with incomplete emptying and fecal urgency. There was no significant association between polypharmacy and multimorbidity with urinary symptoms, prolapse, or sexual dysfunction.ConclusionsPolypharmacy and multimorbidity are common in the urogynecologic population. There is a relationship between greater defecatory distress and polypharmacy and multimorbidity.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 84%

Polypharmacy and Multimorbidity in the Urogynecology Population and Their Effect on Pelvic Floor Symptoms

Zuo

Tellechea

Kohn

et al. 2022

UROGC

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“…Additionally, it should be stressed that as life expectancy increases, so does the number of comorbidities. Barcelos et al emphasize that women with multiple diseases had a 38% higher risk of fracture as compared to those who suffered from one noncommunicable chronic disease only or in whom no disease occurred [27]. Bone fractures and chronic diseases, including arterial hypertension, chronic obstructive pulmonary disease, diabetes mellitus, limit the functioning of the patient, and consequently lower the quality of life.…”

Section: P R E P R I N Tmentioning

confidence: 99%

“…Bone fractures and chronic diseases, including arterial hypertension, chronic obstructive pulmonary disease, diabetes mellitus, limit the functioning of the patient, and consequently lower the quality of life. Therefore, there is an urgent need to increase health awareness in the population to enable patients to lead a healthy lifestyle and to promote active aging [27].…”

Section: P R E P R I N Tmentioning

confidence: 99%

Does the duration of postmenopausal osteoporosis affect life quality and satisfaction?

Górczewska¹,

Jakubowska-Pietkiewicz²

2022

Arch Med Sci

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IntroductionThe rational mental state of patients is necessary for the proper treatment of the disease. Osteoporosis (OP) is a chronic disease that affects all spheres of the patient's life. If it is diagnosed, lifelong treatment is required. Background: The aim of our study was to assess life quality and satisfaction of women with postmenopausal osteoporosis depending on the duration of the disease.Material and methodsThe study was conducted among 198 women aged over 50 years with postmenopausal osteoporosis. For this purpose, the Satisfaction with Life Scale (SWLS), QUALEFFO-41 and a self-authored questionnaire were used.ResultsThe surveyed women assessed their quality of life as moderate and obtained, according to the QUALEFFO-41 scale, an average score of 40.26 ± 16.92 points. The mean result of the level of satisfaction with life, assessed on the SWLS scale, was 19.37 ± 7.31 points, which proves moderate satisfaction with life. Age, education and marital status had a statistically significant impact on the quality of life. ). Life satisfaction was higher in older women as compared to younger subjectsConclusionsThe quality of life significantly worsens with the duration of osteoporosis in the respondents. These results emphasize the need to introduce psychological care and educational programs that would focus on women aged over 50 years.

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“…In addition, a number of lifestyle factors are recognised as important in the pathogenesis of low bone density but are not currently included in FRAX. These include diet [18][19][20][21][22][23][24], physical activity [25,26], and medical history (where the clinician does not consider the patient to have secondary osteoporosis) [27,28]. For this reason, we also examined relationships between these factors and SPR and investigated whether they explained the relationship between SPR and previous fracture.…”

Section: Introductionmentioning

confidence: 99%

Investigating the relationship between self-perception of fracture risk and prior fracture: findings from the Hertfordshire Cohort Study

et al. 2022

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Background Self-perceived risk of fracture (SPR) is associated with fracture independent of FRAX calculated risk. To understand this better we considered whether lifestyle factors not included in the FRAX algorithm and psychosocial factors (social isolation, self-efficacy, or mental health status) explain the relationship between SPR and fracture. Methods We studied 146 UK community-dwelling older adults from the Hertfordshire Cohort Study. SPR ranked as ‘lower’, ‘similar’ and ‘higher’ relative to others of the same age, was assessed by questionnaire. Social isolation was assessed using the six-item Lubben Social Network Scale; self-efficacy was assessed using a shortened General Self-Efficacy Scale (GSE); mental health status was assessed using the anxiety/depression item from the EuroQoL questionnaire. SPR in relation to previous self-reported fracture was examined using logistic regression. Results Among participants of median age 83.4 (IQR 81.5–85.5) years, SPR was lower for 54.1% of participants, similar for 30.8%, and higher for 15.1%; 74.7% reported no previous fractures. Greater SPR was associated with increased odds of previous fractures when adjusting for sex and age only (OR 1.72, 95% CI 1.03–2.87, per higher band of SPR). While further individual adjustment for social isolation (1.73, 1.04–2.89), self-efficacy (1.71, 1.02–2.85), or mental health (1.77, 1.06–2.97) did not attenuate the relationship, individual adjustment for diet quality and number of comorbidities did. Conclusions Adjustment for social isolation, self-efficacy or mental health status did not attenuate the relationship between SPR and fracture. By contrast, lifestyle factors not included in FRAX, such as diet quality, did attenuate relationships, suggesting a possible future area of investigation.

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Multimorbidity is associated with fragility fractures in women 50 years and older: A nationwide cross-sectional study

Cited by 12 publications

References 32 publications

Polypharmacy and Multimorbidity in the Urogynecology Population and Their Effect on Pelvic Floor Symptoms

Polypharmacy and Multimorbidity in the Urogynecology Population and Their Effect on Pelvic Floor Symptoms

Does the duration of postmenopausal osteoporosis affect life quality and satisfaction?

Investigating the relationship between self-perception of fracture risk and prior fracture: findings from the Hertfordshire Cohort Study

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