Osteoporosis onset differences between rural and metropolitan populations: correlation to fracture type, severity, and treatment efficacy

Abstract

Osteoporosis is the prevalent cause of fractures in an ever-aging population, with an established correlation between daily activities and way of life. We aimed to delineate differences in onset of osteoporosis, T-score progression, quality of life, and correlation to prevalence, types, and severity of fractures in age-comparable populations of rural and metropolitan habitats in this multicenter, retrospective double-blind study. We evaluated data derived from the medical files of two comparable groups of osteoporotic patients: group A (n = 530, rural area) and group B (n = 171, metropolitan area). Both groups received comparable treatment for osteoporosis. Comparison was performed on the basis of osteoporosis onset, T-score in a maximum of 8 years follow-up, fracture types [American Academy of Orthopaedic Surgeons (AO) categorization], and type of treatment followed. Quality of life was assessed by use of specialized questionnaires. From the minimum 4-year follow-up of all patients included in the research, there was a statistically significant difference in favor of the rural population in all research parameters. Rural populations presented with osteoporosis at a later age than their metropolitan counterparts, exhibiting favorable T-scores with comparable treatments and simpler fractures (AO categorization). Metropolitan habitats and life therein have a deleterious effect on osteoporosis onset and response to treatment. Rural populations are diagnosed with osteoporosis on a later age, with better compliance and improved treatment outcome. Fracture categorization shows increased severity in the metropolitan populace and a suggested correlation between a poor-quality way of life and decreased activity levels.

Hip Fracture Surgery in Patients Older than 90 Years: Evaluation of Factors that Affect 30-Day Mortality in a Particularly Risky Group

“…Pagonis et al reported that osteoporotic fracture patterns in urban patients are more severe, which is explained by decreased activity level and poor quality of life (23). In the same study, the authors stated that people living in rural areas had a later diagnosis of osteoporosis, and had better treatment outcomes (23).…”

“…In the same study, the authors stated that people living in rural areas had a later diagnosis of osteoporosis, and had better treatment outcomes (23). Men aged >60 years living in rural areas are more active than their urban counterparts, because of work and environmental conditions (24).…”

Incidence of osteoporosis and ambient air pollution in South Korea: a population-based retrospective cohort study

“…However, lifestyle might not influence BMD directly or relatively influence bone size [ 27 ]. Additionally, osteoporosis diagnoses have been confirmed earlier in rural areas than in urban areas [ 28 ]. We found a more hazardous effect of PM 10 on osteoporosis incidence in less urbanized areas.…”

Prevention of osteoporosis: From infancy through older adulthood

“…In older adults, loss of bone mass will occur, but maintaining physical activity levels (including weight-bearing and strength training components) can help to minimize the decrease in bone mineral density [29,51,53e56]. Older adults who live in rural areas and may therefore have more active lifestyles have a later onset of osteoporosis and less severe osteoporotic fractures than those who live in metropolitan areas [57].…”