The impact of incident fractures on health-related quality of life: 5 years of data from the Canadian Multicentre Osteoporosis Study

Abstract

BackgroundVertebral fractures in patients with cystic fibrosis (CF) may contribute to an accelerated decline in lung function and can be a contraindication to lung transplantation. In this study, we examined longitudinal change in bone mineral density (BMD) and the prevalence of vertebral fractures in adult CF patients, without lung-transplant, attending a Canadian specialty clinic.MethodsRetrospective chart review of all patients attending an Adult Cystic Fibrosis Clinic at Hamilton Health Sciences in Hamilton, Canada. Forty-nine of 56 adults met inclusion criteria. Chest radiographs were graded by consensus approach using Genant’s semi-quantitative method to identify and grade fractured vertebrae. Dual x-ray absorptiometry (DXA) scans were also reviewed.ResultsThe mean age of the cohort was 25.2 years (SD 9.4), 43% were male. The mean body mass index (BMI) was 19.8 (2.8) for males and 21.7 (5.1) for females. At baseline, the rate of at least one vertebral fracture was 16.3%; rising to 21.3% (prevalent and incident) after a 3-year follow-up. The mean BMD T-or Z-scores at baseline were −0.80 (SD 1.1) at the lumbar spine, −0.57 (SD 0.97) at the proximal femur, and −0.71 (SD 1.1) at the whole body. Over approximately 4-years, the mean percent change in BMD was −1.93% at the proximal femur and −0.73% at the lumbar spine.ConclusionApproximately one in five CF patients demonstrated at least one or more vertebral fractures. Moderate declines in BMD were observed. Given the high rate of vertebral fractures noted in this cohort of adult CF patients, and the negative impact they have on compromised lung functioning, regular screening for vertebral fractures should be considered on routine chest radiographs.

Impact of Prevalent Fractures on Quality of Life: Baseline Results From the Global Longitudinal Study of Osteoporosis in Women

“…After a hip fracture, mobility, ambulation, and self-care are significantly affected. 4,[18][19][20][21] This reduction in quality of life has been shown to persist for several years. 20 Spine fractures result in severe pain and reductions in general health and vitality.…”

“…4,[18][19][20][21] This reduction in quality of life has been shown to persist for several years. 20 Spine fractures result in severe pain and reductions in general health and vitality. In contrast to hip fractures, the negative impact of spine fractures occurs primarily in those who experienced fracture more recently.…”

“…In contrast to hip fractures, the negative impact of spine fractures occurs primarily in those who experienced fracture more recently. 20 Although some improvement in HRQL may occur over time, reductions in quality of life are long-term. 18,22 In the current study, wrist fractures had a minimal longterm impact on HRQL, a finding that concurs with some other reports.…”

Molecular mechanisms triggered by low-calcium diets

“…Due to the fact that there is no accurate test to determine Ca 2þ deficiency, it is considered that women must meet the recommended Ca 2þ intake levels (52) . Although a low-Ca 2þ diet has been considered as a risk factor for developing osteoporosis, a recent article reviewing several databases for low BMD or for bone loss in healthy men aged 50 years or older has found that dietary Ca 2þ is a weak risk factor for low BMD (53) . The interaction of dietary Ca 2þ content and physical activity seems to be very important to determine adequate BMD.…”

Comparative trends in incident fracture rates for all long-term care and community-dwelling seniors in Ontario, Canada, 2002–2012

“…The consequences of fractures, particularly hip and spine, can be devastating and may be most severe in the elderly [4]. Fractures lead to substantial pain, reduced quality of life, dependence in self-care and mobility, institutionalization, and mortality [7][8][9][10].…”