. Health related quality of life in older people with osteoporotic vertebral fractures: a systematic review and meta-analysis. Osteoporosis International, 27(10), 2891 -2909 . DOI: 10.1007 Peer reviewed version Link to published version (if available): 10.1007/s00198-016-3648-x Link to publication record in Explore Bristol Research PDF-document This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Springer Verlag at doi:10.1007/s00198-016-3648-x. Please refer to any applicable terms of use of the publisher.
University of Bristol -Explore Bristol Research
General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms Purpose: This meta-analysis was conducted to identify if there are any differences between physical and/or mental health related quality of life (HRQoL) in older people with osteoporosis based on conventional T score definitions, and the presence or absence of vertebral fracture.
Methods:A comprehensive search was undertaken using the databases of PubMed, Embase, Medline, Web of Science, and the "grey" literature from 1950 to the end of April 2015. Search terms for vertebral fracture (VF) included VF, osteoporotic fracture, fragility fracture, and spinal fracture. Quality of life was searched using the following terms: quality of life, health related quality of life, HRQoL, and QoL. Strict inclusion and exclusion criteria were used. The standardized mean difference (SMD) was calculated for each HRQoL domain by the difference in means between case and control groups divided by the pooled SD of participants.Results: 16 eligible studies were identified involving 3131 men and women. There was evidence of publication bias and heterogeneity. The meta-analysis showed worse physical (SMD= 0.53, 95% confidence interval (CI) 0.38 to 0.68; P <0.001) and mental (SMD= 0.19, 95%CI 0.05 to 0.33; P= 0.009) HRQoL in osteoporotic older people with vertebral fracture compared to those without fracture. Similar differences were observed for physical HRQoL in further analyses accounting for possible confounding effects of age. Sub-analysis to assess associations between number/severity of fractures and time since fracture were not possible due to small numbers of studies that accounted for age.
Conclusion:Osteoporotic older people with vertebral fracture have worse physical HRQoL than osteoporotic older people without vertebral fracture, even after accounting for age differences.
Keywords
Osteoporosis
Quality of lifeVertebral fracture
Physical health
Mental health
Mini-abstractHealth related quality of life in osteoporotic patients with vertebral fracture is of increasing interest, but relevant studies have yielded debatable results. This systematic review and meta-analysis of 16 observational studies demonstrates a clear association between physical health status and presence of vertebral fra...
