Shah, A and Wu, F and Jones, G and Cicuttini, F and Toh, LS and Laslett, LL, The association between incident vertebral deformities, health-related quality of life and functional impairment: a 10.7-year cohort study, Osteoporosis International ISSN 0937-941X (2021) [Refereed Article]
Copyright International Osteoporosis Foundation and National Osteoporosis Foundation 2021
We aimed to describe longitudinal changes in health-related quality of life (HRQoL) measures associated with incident vertebral deformities (VDs) over 10.7 years. Incident VDs are associated with clinically significant functional impairment in men, and reduction in overall HRQoL in older women. Increasing severity and number of incident VDs are associated with clinically meaningful functional impairment in men, but not women.
Introduction: To describe associations between incident VD and changes in HRQoL and functional ability in older adults over 10.7 years.
Methods: Participants (n = 780) underwent whole-body dual-energy X-ray absorptiometry (DXA) scans at baseline, 2.5, 5.1 and 10.7 years later. VD was defined as ≥ 25% reduction in anterior height relative to posterior height of vertebrae from T4 to L4. An incident VD was defined as a new VD at any follow-up visit. Assessment of Quality of Life (AQoL-4D) questionnaire and Health Assessment Questionnaire-Disability Index (HAQ-DI) were used to assess HRQoL and functional impairment. Changes in AQoL and HAQ-DI associated with incident VD were analysed using multilevel mixed-effects linear regression. Log binomial regression was used to examine clinically relevant changes and effects of severity and number of VD.
Results: The incidence of VD was 37% over 10.7 years. In women, incident VDs were associated with annual reduction in AQoL utility score (β = -0.005, 95% CI -0.008 to -0.002). Men had increased risk of clinically significant reduction in HAQ-DI (IRR = 1.76, 95% CI 1.07-2.89). Men had increased risk of clinically important functional impairment with increasing severity (IRR 1.76, 95% CI 1.04-2.95 for mild vs IRR 1.98, 95% CI 1.13-3.47 for moderate to severe VD) as well as number of incident VD (IRR 1.85, 95% CI 1.17-2.93 for one vs IRR 1.88, 95% CI 0.94-3.78 for ≥ 2 VDs). Such associations were not observed in women.
Conclusions: Incident VDs are associated with clinically significant functional impairment in men, and reduction in overall HRQoL in older women. Increasing severity and number of incident VDs are associated with clinically meaningful functional impairment in men, but not women.
|Item Type:||Refereed Article|
|Keywords:||osteoporosis, vertebral deformity, vertebral fracture, vertebral morphometry, quality of life, physical function|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Clinical sciences|
|Research Field:||Rheumatology and arthritis|
|Objective Group:||Clinical health|
|Objective Field:||Diagnosis of human diseases and conditions|
|UTAS Author:||Shah, A (Mr Anuj Shah)|
|UTAS Author:||Wu, F (Dr Feitong Wu)|
|UTAS Author:||Jones, G (Professor Graeme Jones)|
|UTAS Author:||Laslett, LL (Dr Laura Laslett)|
|Funding Support:||National Health and Medical Research Council (1070586)|
|Deposited By:||Menzies Institute for Medical Research|
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