Abstract

BackgroundOsteoporosis and vertebral fractures represent a major health burden worldwide, and the prevalence of osteoporosis is expected to increase as the world’s population ages. Suffering from vertebral fracture has a substantial impact on the individual’s health-related quality of life (HRQoL), physical function and pain. Complex health challenges experienced by older people with osteoporosis and vertebral fractures call for identification of factors that may influence HRQoL, as some of these factors may be modifiable. The objective is to examine the independent associations between HRQoL, physical function and pain in older women with osteoporosis and vertebral fracture.MethodsThis study has a cross-sectional design, using data from 149 home-dwelling Norwegian women with osteoporosis and vertebral fracture, aged 65+. Data on HRQoL (Short Form 36 (SF-36), Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41)), physical function (walking speed, balance and strength), pain, as well as sociodemographic information were collected. Simple linear regression analyses were conducted and multivariable regression models were fitted to investigate the associations.ResultsLower levels of HRQoL were significantly associated with lower levels of physical function, measured by walking speed, and higher levels of pain. Pain was significantly associated with all of the subscales in SF-36, with the exception of Mental Health and Mental Component Score, and all the subscales of QUALEFFO-41. Walking speed was significantly associated with 5 of 8 subscales of SF-36 (except Bodily Pain, Vitality, Mental Health and Mental Component Score), and with 4 of 6 subscales of QUALEFFO-41 (except Score Pain and Mood).ConclusionThis study shows that pain and walking speed were, independently of one another, associated with HRQoL in older women with osteoporosis and vertebral fracture. These findings can inform clinicians and health managers about the importance of pain management and exercise interventions in health care for this group. Future research should address interventions targeting both physical function and pain with HRQoL as an outcome.RegistrationClincialTrials.gov Identifier: NCT02781974. Registered 18.05.16. Retrospectively registered.

Highlights

  • Osteoporosis is a major health burden worldwide [1], affecting more than 22 million women and 5.5 million men in the European Union [2]

  • Regarding the health-related quality of life (HRQoL) instruments, the subscale with the best score in social function (SF)-36 was SF while in QUALEFFO-41 the highest score was observed in Physical Function

  • In Short Form 36 (SF-36)’s subscale SF, a ceiling effect was found in the 52% who achieved the top score of 100

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Summary

Introduction

Osteoporosis is a major health burden worldwide [1], affecting more than 22 million women and 5.5 million men in the European Union [2]. Vertebral fractures may cause severe pain and loss of function, but can present with mild or no symptoms [5]; this may explain why only 30% of these fractures come to clinical attention. Fractures of this nature have a substantial impact on the individual’s health-related quality of life (HRQoL) [6]. Suffering from vertebral fracture has a substantial impact on the individual’s health-related quality of life (HRQoL), physical function and pain. The objective is to examine the independent associations between HRQoL, physical function and pain in older women with osteoporosis and vertebral fracture

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