Associations of Health-Related Quality of Life, Fear of Falling and Objective Measures of Physical Function with Bone Health in Postmenopausal Women with Low Bone Mass.

Gandham Gandham,Zengin Zengin,Humbert Humbert,Bonham Bonham,Ng Ng,Mcmillan Mcmillan,Ebeling Ebeling,Scott Scott

doi:10.3390/jcm8091370

Abstract

Health-related quality of life (HRQoL) and physical function deteriorate with age and may adversely impact bone health in older adults. We determined associations of objective measures of physical function and HRQoL with bone health in postmenopausal women with low areal bone mineral density (aBMD). Fifty postmenopausal women (64.4 ± 7.7 years old, mean ± standard deviation) with low spine, hip or femoral neck aBMD (T- or Z-score < −1.0) on dual-energy X-ray absorptiometry (DXA) participated. Femoral surface BMD, trabecular, integral and cortical volumetric BMD (vBMD) measurements were obtained using 3D-SHAPER software on DXA. Distal tibial vBMD and microarchitecture were assessed using high-resolution peripheral quantitative computed tomography (HRpQCT). Participants completed self-administered EuroQol-5D (EQ-5D) and modified falls efficacy scale (MFES) questionnaires, and physical function assessments. Stair climb power was positively associated with bone parameters at the hip, femoral neck, and distal tibia (all p < 0.05) in multivariable linear regression. EQ-5D demonstrated no significant associations with bone parameters and MFES was positively associated only with distal tibial cortical vBMD and cortical von Mises stress (both p < 0.05). Objective measures of physical function, particularly muscle power, are more consistently associated with bone parameters compared with self-administered HRQoL questionnaires.

Highlights

Osteoporosis is an age-associated disease largely affecting postmenopausal women due to a steep decline in estrogen levels following menopause [1,2]
Our cross-sectional study in community-dwelling postmenopausal women with low areal bone mineral density (BMD) (aBMD) demonstrates that an objective measure of muscle power is more consistently associated with bone parameters than other clinically relevant objective measures of physical performance, self-reported Health-related quality of life (HRQoL), and fear of falling
Given that physical assessments can be incorporated in clinical settings, they may serve as useful screening tools to help address current underdiagnosis of osteoporosis [28]

Summary

Introduction

Osteoporosis is an age-associated disease largely affecting postmenopausal women due to a steep decline in estrogen levels following menopause [1,2]. The development of cost-effective but reliable methods for identifying individuals at increased risk for poor bone health is important in reducing the burden of osteoporosis. Age-related declines in physical function, in postmenopausal women, are sequentially associated with loss of bone and bone mass [6]. Declining physical activity levels with age contribute to bone fragility and an increasing fracture risk in older adults [6,7]. It is possible that they may have utility for prediction of bone loss in older adults and may be useful for clinicians to identify individuals at risk of poor bone health [9,10]

Methods

Results

Conclusion