Health-related quality of life with vertebral fracture, lumbar spondylosis and knee osteoarthritis in Japanese men: the ROAD study
ABSTRACT SummaryThis study examined associations of VFx, lumbar spondylosis and knee OA with QOL in 767 men over 40years old from the ROAD
study (mean, 69.7years.). Multiple regression analysis showed VFx and knee OA as significantly associated with lower PCS
scores, but lumbar spondylosis was not.
PurposeLittle data have been accumulated regarding associations of vertebral fracture (VFx), lumbar spondylosis and knee osteoarthritis
(OA) with quality of life (QOL) in men. The purpose of the present study is to clarify the impact of these diseases on QOL
parameters such as the Medical Outcomes Study Short Form 8 (SF-8) and the EuroQOL (EQ-5D). In addition, to provide greater
insight into the magnitude of QOL loss, a comparison was made with cerebral stroke.
MethodsFrom the 3,040 participants in the ROAD study, this study analyzed 767 men over 40years who had completed the questionnaires
(mean, 69.7years.). Vertebral fracture was assessed by lateral radiography of the lumbar spine. Lumbar spondylosis and knee
OA were defined as Kellgren/Lawrence grade ≥3. Cerebral stroke was assessed by self-report.
ResultsMultiple regression analysis after adjustments for age, body mass index and presence of the above four diseases showed VFx
was significantly associated with lower scores in physical function (PF), role physical (RP), bodily pain (BP) and vitality
(VT) domains as well as physical component summary (PCS). Knee OA were significantly associated with lower scores in PF, RP,
BP and PCS scores. Lumbar spondylosis was not associated with any domains of the SF-8. Lumbar spondylosis and knee OA were
significantly associated with EQ-5D utility scores, but VFx was not. The impact for VFx on BP, VT and PCS scores was larger
than cerebral stroke.
ConclusionsThis study revealed that VFx and knee OA impaired physical QOL in men, rather than lumbar spondylosis.
KeywordsQuality of life–Vertebral fracture–Lumbar spondylosis–Knee osteoarthritis–Men
- SourceAvailable from: Andrew A Guccione[show abstract] [hide abstract]
ABSTRACT: The purpose of this study was to identify associations between specific medical conditions in the elderly and limitations in functional tasks; to compare risks of disability across medical conditions, controlling for age, sex, and comorbidity; and to determine the proportion of disability attributable to each condition. The subjects were 709 noninstitutionalized men and 1060 women of the Framingham Study cohort (mean age 73.7 +/- 6.3 years). Ten medical conditions were identified for study: knee osteoarthritis, hip fracture, diabetes, stroke, heart disease, intermittent claudication, congestive heart failure, chronic obstructive pulmonary disease, depressive symptomatology, and cognitive impairment. Adjusted odds ratios were calculated for dependence on human assistance in seven functional activities. Stroke was significantly associated with functional limitations in all seven tasks; depressive symptomatology and hip fracture were associated with limitations in five tasks; and knee osteoarthritis, heart disease, congestive heart failure, and chronic obstructive pulmonary disease, were associated with limitations in four tasks each. In general, stroke, depressive symptomatology, hip fracture, knee osteoarthritis, and heart disease account for more physical disability in noninstitutionalized elderly men and women than other diseases.American Journal of Public Health 04/1994; 84(3):351-8. · 3.93 Impact Factor
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ABSTRACT: IntroductionThe objective of this study was to clarify secular changes in the prevalence and cumulative incidence of vertebral fractures (VFx) among the general inhabitants of Miyama, a rural Japanese community. MethodsA cohort of 1,543 inhabitants aged 40–79years was established using resident registration in 1989. Of these, 400 participants were selected and divided into four age strata, each containing 50 men and 50 women. Participants completed a self-administered questionnaire and anthropometric measurements were taken. In 1990, baseline radiographic examinations of the thoracolumbar spine in anteroposterior and lateral views were performed. Radiographic examinations of the same sites were performed on the same participants in 2000. All VFx were diagnosed by the same experienced orthopedic surgeon. Evaluation of radiographic surveys after 10years was completed for 287 of the 400 participants (132 men, 155 women; 71.8%). ResultsThe prevalences of VFx at follow-up in 2000 for subjects in their 50s, 60s, 70s, and 80s were 2.9%, 10.3%, 13.2%, and 25.0% for men, and 2.1%, 9.1%, 20.5%, and 54.2% for women, respectively. Prevalence in the present study was compared with that collected in 1990, showing improvements over time for men and women in their 50s, 60s, and 70s. Future problems with osteoporotic fractures in Japan might, thus, be less severe than previously predicted. Cumulative incidence over 10years was detected by the number of incident cases divided by the number of all participants in the initial study. Incident cases were defined by two criteria. First, cases with prevalent VFx were excluded from both the numerators and the denominators. In this analysis, the cumulative incidence of the cases with first VFx was detected. Secondly, the cumulative incidence including the subjects who had suffered from the prevalent fractures and with an increased number of VFx in the following 10years were calculated. This analysis clarified the cumulative incidence of cases with and without previous VFx. Incidence over 10years of subjects in their 40s, 50s, 60s, and 70s with first VFx were 2.2%, 4.9%, 5.1%, and 10.8% for men, and 2.1%, 4.5%, 14.0%, and 22.2% for women, respectively. By contrast, if new cases were defined as including subjects who had suffered from previous fractures, but displayed an increased number of VFx, cumulative incidences for subjects in their 40s, 50s, 60s, and 70s were 2.1%, 8.3%, 10.0%, and 12.2% for men, and 2.1%, 6.1%, 18.0%, and 22.4% for women, respectively.Archives of Osteoporosis 04/2012; 1(1):43-49.
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ABSTRACT: The aim of this study was to examine the pattern of mortality following osteoporotic fractures at the spine, shoulder, hip, and forearm. We studied 2,847 patients with fractures at these sites identified from the radiology department in Malmö, Sweden. Poisson regression was used to compute mortality immediately after the fracture and with time. Mortality immediately after fracture was significantly higher in fracture cases than in the general population except for forearm fractures in both men and women. Mortality was higher in men than in women, but not different when adjusted for sex-specific population risks. For spine, shoulder, and hip fracture, mortality fell after the 1st year, an effect that was most marked for patients with spine fractures. The decrease in mortality risk with time was significant for hip, vertebral, and shoulder fracture. We conclude that the risk of death is increased in patients with osteoporotic fractures and that the highest risk is found immediately after the fracture event. The decreasing mortality with time after fracture may be due in part to a decrease in deaths causally related to the fracture. The extent to which early intervention for osteoporosis might avoid some of these deaths is unknown.Osteoporosis International 02/2004; 15(1):38-42. · 4.04 Impact Factor