RESUMO
OBJECTIVE: The aim of this study was to examine associations between empirically derived dietary pattern scores and cognition, as well as risk of cognitive decline, over an average of 4.6 (± 0.3) years in older men. MATERIALS AND METHODS: This analysis was conducted as part of the Osteoporotic Fractures in Men (MrOS) prospective cohort study. Diet was assessed at Visit 1 (3/2000-4/2002) by food frequency questionnaire, and dietary patterns (Western and Prudent) were derived by factor analysis. The analytic cohort comprised 4231 community-dwelling American men who were aged 65 years or more. Cognitive function was assessed with the Modified Mini-Mental State exam (3MS) and the Trails B test at Visit 1 and at Visit 2 (3/2005-5/2006). Associations between dietary pattern score and cognition and risk of cognitive decline were estimated using mixed effects regression models. Model 1 was adjusted for age, clinic site and total energy intake (TEI). Model 2 was further adjusted for calcium and vitamin D supplement use, body mass index (BMI), physical activity, smoking, diabetes and hypertension (Western diet group) and education, calcium and vitamin D supplement use, depression, BMI, physical activity, smoking and stroke (Prudent diet group). RESULTS: Adherence to the Western dietary pattern was associated with higher 3MS scores and shorter Trails B test time at Visit 1 in Model 2. Adherence to the Prudent dietary pattern was associated with higher 3MS scores in Model 1 but not Model 2. There were no independent associations between dietary pattern scores and risk of cognitive decline 4.6 (± 0.3) years later at Visit 2. CONCLUSION: The results do not support a robust protective effect of the Prudent dietary pattern on cognition in the MrOS cohort. Associations between the Western dietary pattern and better cognitive scores should be interpreted with caution. Further research is needed to understand the complex interactions between dietary patterns and cognition in older men.
Assuntos
Cognição , Disfunção Cognitiva , Dieta , Fraturas por Osteoporose , Humanos , Masculino , Idoso , Estudos Prospectivos , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/epidemiologia , Fraturas por Osteoporose/epidemiologia , Fraturas por Osteoporose/etiologia , Fraturas por Osteoporose/psicologia , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Suplementos Nutricionais , Comportamento Alimentar/psicologia , Fatores de Risco , Estudos de Coortes , Padrões DietéticosAssuntos
Terapia por Exercício , Fraturas do Quadril , Humanos , Fraturas do Quadril/reabilitação , Terapia por Exercício/métodos , Depressão/reabilitação , Depressão/etiologia , Idoso , Fraturas por Osteoporose/reabilitação , Fraturas por Osteoporose/prevenção & controle , Fraturas por Osteoporose/psicologia , Metanálise como AssuntoAssuntos
Terapia por Exercício , Fraturas do Quadril , Idoso , Humanos , Depressão/reabilitação , Depressão/etiologia , Terapia por Exercício/métodos , Fraturas do Quadril/reabilitação , Metanálise como Assunto , Fraturas por Osteoporose/reabilitação , Fraturas por Osteoporose/prevenção & controle , Fraturas por Osteoporose/psicologia , Resultado do Tratamento , Revisões Sistemáticas como AssuntoRESUMO
This 5-year longitudinal study investigated the relationship between depressive symptoms and fracture risk in a large Japanese cohort. Depressive symptoms were a significant risk factor for hip fractures in women. PURPOSE: A relationship between depressive symptoms and fractures has not been clearly demonstrated. We aimed to investigate the relationship between depressive symptoms and 5-year fracture risk in the Japan Public Health Center-based Prospective Study for the Next Generation. METHODS: From 2011 to 2016, 114,092 participants were enrolled, and a follow-up survey was conducted 5 years later. We analyzed 30,552 men and 38,063 women aged 40-74 years who had no past fractures at baseline. Presence of depressive symptoms was defined as a modified 11-item Center for Epidemiological Studies Depression Scale score of 8 or higher, a history of depression, or use of antidepressants. Subjects were asked to report vertebral, upper limb, and/or hip fractures, except for traffic or work accidents, that occurred during the follow-up period. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for fracture were analyzed via logistic regression analysis to evaluate the relationship between depressive symptoms and fracture. RESULTS: Women with depressive symptoms demonstrated a high AOR for hip fractures (AOR: 2.78, 95% CI: 1.30 - 5.92); this result was consistent in post menopause women. In men, this association was not found for any age group or any type of fracture. CONCLUSIONS: Depressive symptoms in women may increase the risk of hip fractures. Further studies are required to explore this relationship in more detail.
Assuntos
Depressão , Fraturas por Osteoporose , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Idoso , Japão/epidemiologia , Estudos Prospectivos , Adulto , Depressão/epidemiologia , Fraturas por Osteoporose/epidemiologia , Fraturas por Osteoporose/psicologia , Fraturas por Osteoporose/etiologia , Incidência , Fatores de Risco , Estudos Longitudinais , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/etiologia , SeguimentosRESUMO
OBJECTIVE: To understand perceptions on rehabilitation after vertebral fracture, non-pharmacological strategies, and virtual care from the perspective of individuals living with vertebral fractures. DESIGN AND SETTING: We conducted semi-structured interviews online and performed a thematic and content analysis from a post-positivism perspective. PARTICIPANTS: Ten individuals living with osteoporotic vertebral fractures (9F, 1â M, aged 71 ± 8 years). RESULTS: Five themes emerged: pain is the defining limitation of vertebral fracture recovery; delayed diagnosis impacts recovery trajectory; living with fear; being dissatisfied with fracture management; and "getting back into the game of life" using non-pharmacological strategies. CONCLUSION: Participants reported back pain and an inability to perform activities of daily living, affecting psychological and social well-being. Physiotherapy, education, and exercise were considered helpful and important to patients; however, issues with fracture identification and referral limited the use of these options. Participants believed that virtual rehabilitation was a feasible and effective alternative to in-person care, but perceived experience with technology, cost, and individualization of programs as barriers.
Assuntos
Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Humanos , Fraturas da Coluna Vertebral/diagnóstico , Fraturas da Coluna Vertebral/etiologia , Fraturas da Coluna Vertebral/terapia , Atividades Cotidianas , Fraturas por Osteoporose/terapia , Fraturas por Osteoporose/psicologia , Dor nas Costas , Modalidades de FisioterapiaRESUMO
BACKGROUND: Compromised bone health is often associated with depression and chronic pain. OBJECTIVE: To examine: (1) the experience of existing depression and chronic nonfracture pain in patients with a fragility fracture; and (2) the effects of the fracture on depression and pain. DESIGN: A phenomenological study guided by Giorgi's analytical procedures. SETTING AND PARTICIPANTS: Fracture patients who reported taking prescription medication for one or more comorbidities, excluding compromised bone health. MAIN VARIABLES STUDIED: Patients were interviewed within 6 weeks of their fracture, and 1 year later. Interview questions addressed the recent fracture and patients' experience with bone health and their other health conditions, such as depression and chronic pain, including the medications taken for these conditions. RESULTS: Twenty-six patients (5 men, 21 women) aged 45-84 years old with hip (n = 5) and nonhip (n = 21) fractures were recruited. Twenty-one participants reported depression and/or chronic nonfracture pain, of which seven reported having both depression and chronic pain. Two themes were consistent, based on our analysis: (1) depression and chronic pain overshadowed attention to bone health; and (2) the fracture exacerbated reported experiences of existing depression and chronic pain. CONCLUSION: Experiences with depression and pain take priority over bone health and may worsen as a result of the fracture. Health care providers treating fragility fractures might ask patients about depression and pain and take appropriate steps to address patients' more general emotional and physical state. PATIENT CONTRIBUTION: A patient representative was involved in the study conception, data interpretation and manuscript writing.
Assuntos
Dor Crônica , Fraturas por Osteoporose , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea , Dor Crônica/etiologia , Depressão/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fraturas por Osteoporose/complicações , Fraturas por Osteoporose/psicologia , Fraturas por Osteoporose/terapia , Pesquisa QualitativaRESUMO
CONTEXT: Fracture on therapy should motivate better antifracture medication adherence. OBJECTIVE: This study aimed to describe osteoporosis medication adherence in women before and following a fracture. METHODS: This retrospective cohort analysis of antifracture medication possession ratios (MPR) among women in the Manitoba BMD Registry (1996-2013) included menopausal women who started antifracture drug therapy after a dual-energy x-ray absorptiometry (DXA)-BMD assessment with follow-up for 5 years during which a nontraumatic fracture occurred at least 1 year after starting treatment. Linked prescription records determined medication adherence (estimated by MPR) in 1-year intervals. The variable of interest was MPR in the year before and after the year in which the fracture occurred, with subgroup analyses according to duration of treatment pre-fracture. We chose an MPR of ≥ 0.50 to indicate minimum adherence needed for drug efficacy. RESULTS: There were 585 women with fracture on therapy, 193 (33%) had hip or vertebral fracture. Bisphosphonates accounted for 82.2% of therapies. Median MPR the year prior to fracture was 0.89 (IQR, 0.49-1.0) and 0.69 (IQR, 0.07-0.96) the year following the year of fracture (P < 0.0001). The percentage of women with MPR ≥ 0.5 pre-fracture was 73.8%, dropping to 57.3% post-fracture (P < 0.0001); when restricted to hip/vertebral fracture, results were similar (58.2% to 33.3%; P < 0.002). Among those with pre-fracture MPR < 0.5, only 21.7% achieved a post-fracture MPR ≥ 0.5. CONCLUSIONS: Although fracture on therapy may motivate sustained/improved adherence, MPR remains low or even declines after fracture in many. This could reflect natural decline in MPR with time but is paradoxical to expectations. Fracture on therapy represents an important opportunity for clinicians to reemphasize treatment adherence.
Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Adesão à Medicação/estatística & dados numéricos , Osteoporose/tratamento farmacológico , Fraturas por Osteoporose/epidemiologia , Absorciometria de Fóton , Idoso , Densidade Óssea/efeitos dos fármacos , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Manitoba/epidemiologia , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Osteoporose/complicações , Fraturas por Osteoporose/prevenção & controle , Fraturas por Osteoporose/psicologia , Sistema de Registros/estatística & dados numéricos , Estudos RetrospectivosAssuntos
Fixação de Fratura/métodos , Comportamentos Relacionados com a Saúde , Motivação , Osteoporose/complicações , Fraturas por Osteoporose/cirurgia , Idoso de 80 Anos ou mais , Feminino , Humanos , Osteoporose/psicologia , Osteoporose/cirurgia , Fraturas por Osteoporose/etiologia , Fraturas por Osteoporose/psicologiaRESUMO
BACKGROUND: Osteoporotic fracture is a serious complication of osteoporosis. The long-term therapy process and the heavy restriction to physical activities give rise to a psychological burden on osteoporotic fracture patients, especially older adult patients. Psychological nursing interventions significantly alleviate negative emotional reactions in cancer patients. This research aimed to investigate the function of psychological nursing interventions in the reduction of depression and anxiety and the improvement of quality of life in older adult patients with osteoporotic fracture. METHODS: Osteoporotic fracture patients (n = 106) were divided into control group (n = 53) or intervention group (n = 53). In the control group, the participants were given conventional nursing care. In the intervention group, the participants were given psychological nursing interventions. Anxiety, depression, and quality of life were evaluated and compared between the two groups. RESULTS: After 5 weeks of psychological nursing intervention, the anxiety and depression scores significantly decreased in the intervention group. The Mental Function in Quality of Life Questionnaire of the European Foundation for Osteoporosis score also decreased in the intervention group. LINKING EVIDENCE TO ACTION: Psychological nursing interventions alleviate anxiety and depression in older adult osteoporotic fracture patients and enhance their mental function.
Assuntos
Transtornos de Ansiedade/enfermagem , Transtorno Depressivo/enfermagem , Enfermagem Baseada em Evidências/normas , Fraturas por Osteoporose/enfermagem , Fraturas por Osteoporose/psicologia , Enfermagem Psiquiátrica/normas , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Resultado do TratamentoAssuntos
COVID-19 , Osteoporose , Fraturas por Osteoporose , Serviços Preventivos de Saúde/normas , Qualidade de Vida , Risco Ajustado , Idoso , Conservadores da Densidade Óssea/uso terapêutico , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Osteoporose/complicações , Osteoporose/prevenção & controle , Fraturas por Osteoporose/mortalidade , Fraturas por Osteoporose/prevenção & controle , Fraturas por Osteoporose/psicologia , Risco Ajustado/métodos , Risco Ajustado/normas , Fatores de Risco , SARS-CoV-2 , Prevenção Secundária/métodosRESUMO
OBJECTIVES: This study aimed to identify factors, including physical functions and activities that affect quality of life (QOL) at discharge among patients with osteoporotic vertebral fractures. METHODS: Patients with osteoporotic vertebral fractures were included in our prospective cohort study. Multiple regression analysis was performed to determine the predictors of QOL at discharge using two models: model 1, basic medical information and physical functions at admission, and model 2, basic medical information, physical function, and activity after 4 weeks of admission. RESULTS: Multiple regression analysis (standard partial regression coefficients) using model 1 identified L2 to L4 bone mineral density (-0.2), Visual Analog Scale for pain during activity at admission (-0.31), and Revised Hasegawa Dementia Scale (HDS-R) score at admission (0.64) as factors affecting QOL at discharge. Multiple regression analysis using model 2 identified HDS-R at admission (0.64), Pain Catastrophizing Scale score at 4 weeks (-0.34), and knee extension muscle strength at 4 weeks (0.28) as factors affecting QOL at discharge. CONCLUSIONS: Our results suggest that if patients have high bone mineral density, intense pain, and low cognitive function at admission, then low QOL at discharge will be predicted; however, improvement of pain catastrophizing and knee extension muscle strength during first the 4 weeks of admission may be able to improve QOL at discharge. Because patients in this study were Japanese only, it is important to exercise caution when applying our results to other populations.
Assuntos
Regras de Decisão Clínica , Fraturas por Osteoporose , Alta do Paciente , Qualidade de Vida , Fraturas da Coluna Vertebral , Idoso , Idoso de 80 Anos ou mais , Demência/complicações , Demência/diagnóstico , Feminino , Seguimentos , Fixação de Fratura , Humanos , Masculino , Fraturas por Osteoporose/diagnóstico , Fraturas por Osteoporose/fisiopatologia , Fraturas por Osteoporose/psicologia , Fraturas por Osteoporose/cirurgia , Medição da Dor , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/psicologia , Prognóstico , Estudos Prospectivos , Qualidade de Vida/psicologia , Recuperação de Função Fisiológica , Fraturas da Coluna Vertebral/diagnóstico , Fraturas da Coluna Vertebral/fisiopatologia , Fraturas da Coluna Vertebral/psicologia , Fraturas da Coluna Vertebral/cirurgia , Coluna Vertebral , Escala Visual AnalógicaRESUMO
PURPOSE: No study has investigated the clinical and radiographic risk factors for the deterioration of quality of life (QOL) beyond 6 months after osteoporotic vertebral fractures (OVF). The purpose of this study was to identify the predictors associated with poor QOL improvement after OVF. METHODS: This post hoc analysis included 166 women aged 65-85 years with acute 1-level OVFs. For the patient-reported outcome measures, scores on the European Quality of Life-5 Dimensions (EQ-5D) scale, and visual analogue scale (VAS) for low back pain were used. Lateral radiography at 0, 12, and 48 weeks and magnetic resonance imaging (MRI) at enrollment and at 48 weeks were performed. The associations between baseline variables with change scores for EQ-5D were investigated using a multiple linear regression model. RESULTS: Univariate analysis showed that time since fracture, EQ-5D score, and VAS for low back pain at 0 week showed significant association with increased EQ-5D score from 0 to 48 weeks. According to the multiple regression analysis, the following equation was obtained: increased EQ-5D score from 0 to 48 weeks = 1.305 - 0.978 × EQ-5D at 0 week - 0.021 × VAS for low back pain at 0 week - 0.006 × age + (fluid-intensity T2-weighted MR image patterns: - 0.037, except for fluid-intensity T2-weighted MR image patterns: + 0.037). CONCLUSION: In conclusion, older patients with severe low back pain and fluid-intensity T2-weighted MR image patterns were more likely to have lower QOL improvements after OVFs and may therefore need extra support to improve QOL.
Assuntos
Fraturas por Osteoporose/diagnóstico por imagem , Qualidade de Vida/psicologia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Fraturas por Osteoporose/psicologia , Estudos Prospectivos , Fatores de Risco , Fraturas da Coluna Vertebral/psicologiaRESUMO
Osteoporotic fractures comprise a deadly disease which has ascending epidemiology in the 21st century. Cha-racterized by inadequate force impulses which cause breaks of bone tissue in key places for traumatology: proximal femur, spine. This is a severe economic, social, and health problem. The first condition for recovery after fracture is obtaining proper qualification for surgical treatment. Next the surgery must be made as fast as possible in order to provide internal diagnostics, while simultaneously maintaining the patient's safety. It's very important to create optimal conditions for bone healing. The essence of the problem "osteoporotic fractures" is low bone mineral density (BMD). It was found that in research 'in vivo', it is possible to reach a higher value of this factor via supplementation with ossein-hydroxyapatite complex (OHC) as compared to standard Calcium Salts.
Assuntos
Durapatita/uso terapêutico , Consolidação da Fratura/efeitos dos fármacos , Fraturas por Osteoporose/diagnóstico , Fraturas por Osteoporose/psicologia , Fraturas por Osteoporose/cirurgia , Pandemias , Médicos/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fraturas por Osteoporose/epidemiologiaRESUMO
Background: People with osteoporotic vertebral compression fractures (VCFs) have decreased health-related quality of life (HRQoL). Yoga and mindfulness are methods that can promote well-being. Objective: The aim of this article was to explore the effect of mindfulness and modified medical yoga on HRQoL, stress, sleep, and pain in people 60 years or older with a diagnosed osteoporotic VCF. Design: The School of Osteoporosis in Linköping (SOL) is a pilot study with randomized groups. Materials and Methods: The SOL-study was scheduled to once a week for 10 weeks. Ten people were randomized to a theory (T) group, and ten people were randomized to a theory and mindfulness/medical yoga (MMY) group. The educational sessions lasted 60 min and were similar for the groups, but they took place at different facilities. An experienced physiotherapist supervised the MMY sessions for 60 min. Sleep quality and present stress experience were measured on a symmetric Likert scale. The numeric rating scale was used for pain, and EQ-5D, RAND-36, and Qualeffo-41 were used for HRQoL. The patient enablement instrument (PEI) was used to reflect how the participants coped with their illness. Results: Eight women in the MMY-group and seven women in the T-group completed the SOL study interventions. The adherence to the intervention program was 89% in the MMY-group and 87% in the T-group. There was no adverse consequence of the MMY training. After the 10-week intervention period, sleep quality (p = 0.018) and present stress (p = 0.043), but not perceived pain were improved in the MMY-group. The social function (SF) domain was improved in the MMY-group that was measured by both RAND-36 (p = 0.028) and Qualeffo-41 (p = 0.012). There was a trend toward a better PEI-score in the MMY-group compared with the T-group postintervention (p = 0.089). Conclusion: This article suggests that mindfulness and modified medical yoga supervised by a skilled physiotherapist may be a feasible way to improve SF, sleep, and stress in older women with osteoporotic VCFs.
Assuntos
Atenção Plena , Manejo da Dor/métodos , Qualidade de Vida , Sono , Fraturas da Coluna Vertebral/complicações , Estresse Psicológico/terapia , Yoga , Atividades Cotidianas , Adaptação Psicológica , Idoso , Feminino , Fraturas por Compressão/complicações , Fraturas por Compressão/psicologia , Humanos , Meditação , Osteoporose , Fraturas por Osteoporose/complicações , Fraturas por Osteoporose/psicologia , Dor/etiologia , Projetos Piloto , Fraturas da Coluna Vertebral/psicologia , Coluna Vertebral/patologia , Estresse Psicológico/etiologia , MulheresRESUMO
Changes in health-related quality of life (QoL) due to hip, humeral, ankle, spine, and distal forearm fracture were measured in Russian adults age 50 years or more over the first 18 months after fracture. The accumulated mean QoL loss after hip fracture was 0.5 and significantly greater than after fracture of the distal forearm (0.13), spine (0.21), proximal humerus (0.26), and ankle (0.27). INTRODUCTION: Data on QoL following osteoporotic fractures in Russia are scarce. The present study evaluated the impact of hip, vertebral, proximal humerus, distal forearm, and ankle fracture up to 18 months after fracture from the Russian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study. METHODS: Individuals age ≥ 50 years with low-energy-induced humeral, hip, clinical vertebral, ankle, or distal forearm fracture were enrolled. After a recall of pre-fracture status, HRQoL was prospectively collected over 18 months of follow-up using EQ-5D-3L. Multivariate regression analysis was used to identify determinants of QALYs loss. RESULTS: At 2 weeks, patients with hip fracture (n = 223) reported the lowest mean health state utility value (HSUV) compared with other fracture sites. Thereafter, utility values increased but remained significantly lower than before fracture. For spine (n = 183), humerus (n = 166), and ankle fractures (n = 214), there was a similar pattern of disutility with a nadir within 2 weeks and a progressive recovery thereafter. The accumulated mean QoL loss after hip fracture was 0.5 and significantly greater than after fracture of the distal forearm (0.13), spine (0.21), proximal humerus (0.26), and ankle (0.27). Substantial impairment in self-care and usual activities immediately after fracture were important predictors of recovery across at all fracture sites. CONCLUSIONS: Fractures of the hip, vertebral, distal forearm, ankle, and proximal humerus incur substantial loss of QoL in Russia. The utility values derived from this study can be used in future economic evaluations.
Assuntos
Fraturas por Osteoporose/economia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Traumatismos do Tornozelo/economia , Traumatismos do Tornozelo/psicologia , Efeitos Psicossociais da Doença , Feminino , Traumatismos do Antebraço/economia , Traumatismos do Antebraço/psicologia , Fraturas do Quadril/economia , Fraturas do Quadril/psicologia , Humanos , Fraturas do Úmero/economia , Fraturas do Úmero/psicologia , Masculino , Pessoa de Meia-Idade , Fraturas por Osteoporose/psicologia , Anos de Vida Ajustados por Qualidade de Vida , Federação Russa/epidemiologia , Fraturas da Coluna Vertebral/economia , Fraturas da Coluna Vertebral/psicologiaRESUMO
Between 1 and 2% of people aged 50 years and over living at home in France are likely to experience a fragility fracture each year. Three-quarters of these individuals are not diagnosed with osteoporosis and lose the opportunity for appropriate care. PURPOSE: To estimate the incidence of fragility fractures in France and to describe the characteristics of individuals with such fractures and of their fractures. METHODS: In April-May 2018, a postal survey was performed in France targeting a representative panel of 15,000 individuals aged ≥ 50 years, who were invited to complete a questionnaire. If they reported experiencing a fracture in the previous 3 years, they were asked to provide information on demographics, fracture type, risk factors for fractures and osteoporosis diagnosis. Only fragility fractures were considered, and these were classified as major (associated with increased mortality) or minor, based on the fracture site. RESULTS: Around 13,914 panellists returned an exploitable questionnaire (92.8%). About 425 participants reported ≥ 1 fragility fracture (453 fractures), corresponding to a 12-month incidence rate of 1.4% [95%CI: 1.2, 1.6]. Incidence was higher in women (1.99% [1.87, 2.05]) than in men (0.69% [0.38, 0.86]) and increased with age. Around 157 fractures (34.6%) were classified as major. Participants reporting major fractures were older than those reporting minor fractures (mean age: 72.6 ± 11.3 vs 67.1 ± 10.6) and more likely to report previous corticosteroid use (odds ratio: 1.90 [95%CI: 1.13, 3.18]). No other patient characteristic was associated with fracture severity. About 117 participants with fractures (27.5%) had undergone bone densitometry, and 97 (22.8%) declared having received a diagnosis of osteoporosis. CONCLUSIONS: Around 340,000 people aged ≥ 50 years living at home in France are estimated to experience osteoporotic fractures each year. However, > 75% of panellists reporting fractures were never diagnosed with osteoporosis and thus did not have the opportunity to receive appropriate care.
Assuntos
Fraturas Ósseas/epidemiologia , Osteoporose/epidemiologia , Fraturas por Osteoporose/epidemiologia , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Fraturas Ósseas/psicologia , França/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Razão de Chances , Osteoporose/psicologia , Fraturas por Osteoporose/psicologia , Fatores de RiscoRESUMO
Over 6â¯million people in Germany suffer from osteoporosis; approximately half of all women over 70 years old and approximately 1 in 5 men over 70 years old are affected. The most relevant clinical consequences of the disease are fractures leading to a clear impairment in the quality of life. Furthermore, following an osteoporotic fracture especially of the hip or vertebra there is increased mortality. Despite higher individual and socioeconomic relevance, too few patients with osteoporosis still receive adequate treatment. Based on the current guidelines of the governing body for osteology (DVO) the indications for specific medicinal treatment can be determined. Furthermore, the selection of the suitable osteoporosis medication can be carried out by considering several factors, including individual ones.
Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Osteoporose/diagnóstico , Osteoporose/tratamento farmacológico , Fraturas por Osteoporose/diagnóstico , Fraturas por Osteoporose/tratamento farmacológico , Idoso , Feminino , Alemanha , Humanos , Masculino , Osteoporose/psicologia , Fraturas por Osteoporose/psicologia , Guias de Prática Clínica como Assunto , Qualidade de VidaRESUMO
Objectives: This study aimed to investigate health state utility values in eight health states related to osteoporosis and osteoporotic fractures using time trade-off (TTO) technique among postmenopausal Korean women.Methods: Scenarios describing eight health states including osteoporosis and hip, vertebral, post-hip, post-vertebral, ankle, humerus, and wrist fractures were developed and presented to 500 female participants aged 45 to 59 years who were selected with probability proportionate to age group and region for this investigation. Each health states valuation was derived using the trade-off (TTO) technique. Ten years of a given health state was traded off with a shorter length of time in full health.Results: Mean scores of each state were calculated. Osteoporosis scored the highest (0.669 ± 0.155), followed by wrist fracture (0.656 ± 0.151). Hip (0.298 ± 0.158) and vertebral (0.298 ± 0.160) fractures were found to be the worst health states. Post-hip (0.446 ± 0.159) and post-vertebral fractures (0.455 ± 0.160) were also considered undesirable states. All fractures were associated with disutilities, ranging from a mean of -0.013 to -0.371. These values were statistically significant (p < 0.0001). Hip and vertebral fractures are among the most serious consequences of osteoporotic fractures.Conclusions: The vertebral and hip fractures marked the lowest utility scores among post-menopausal women in Korea.
Assuntos
Nível de Saúde , Osteoporose Pós-Menopausa/psicologia , Fraturas por Osteoporose/psicologia , Anos de Vida Ajustados por Qualidade de Vida , Feminino , Indicadores Básicos de Saúde , Fraturas do Quadril/etiologia , Fraturas do Quadril/psicologia , Humanos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/complicações , Probabilidade , República da Coreia , Fraturas da Coluna Vertebral/etiologia , Fraturas da Coluna Vertebral/psicologia , Fatores de TempoRESUMO
Approximately 20% of men and women aged 50 years or older will present with a vertebral fragility fracture - a prevalence that steadily increases with age. The condition may be associated with severe pain and disability, significant reductions in overall quality of life, mobility, social participation, sleep quality and increased fear for the future. There is, however, no current consensus on what constitutes the best management of symptomatic vertebral fractures. Moreover, evidence supporting common treatment approaches is scarce and often of poor quality. The lack of adequate management of VFF and associated osteoporosis and the burden of this condition to patient and society are estimated to increase substantially in coming years as recurrent, disabling episodes are set to occur. This chapter will address these issues, including a discussion on existing care pathways for vertebral fragility fractures, and an overview of the evidence supporting recommendations of the main international clinical practice guidelines.
Assuntos
Dor nas Costas/terapia , Fraturas por Osteoporose/terapia , Fraturas da Coluna Vertebral/terapia , Idoso , Dor nas Costas/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fraturas por Osteoporose/psicologia , Manejo da Dor/métodos , Guias de Prática Clínica como Assunto , Qualidade de Vida/psicologia , Fraturas da Coluna Vertebral/psicologia , VertebroplastiaRESUMO
We translated and adapted transculturally the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) for Korean patients. The translated Korean version of QUALEFFO-41 showed satisfactory reliability and validity. PURPOSE: The aim of this study was to translate the QUALEFFO-41 for Korean patients and then validate the Korean version of QUALEFFO-41. METHODS: Translation and transcultural adaptation of the QUALEFFO-41 was conducted according to the international recommendations. Ninety-seven patients (mean age, 73.6 years) with osteoporosis were participated in validating the Korean version of QUALEFFO-41. To test reliability, internal consistency was evaluated using Cronbach's alpha coefficient. To test validity, convergent validity was assessed using correlation with the SF-12 and EQ-5D and discriminant validity was assessed using ROC curve analysis. RESULTS: The English version of QUALEFFO-41 was translated and adapted to Korean without notable discrepancies. The Korean QUALEFFO-41 had good reliability with Cronbach's alpha ranging from 0.733 to 0.942. QUALEFFO-41 had good correlations to SF-12 and EQ-5D. Compared with subjects without history of vertebral fracture (VF), those with history of VF showed significantly worse scores according to QUALEFFO-41, but not according to SF-12 or EQ-5D. ROC curve analysis revealed that the physical function domain of QUALEFFO-41 had significant ability to discriminate between subjects with and without history of VF, while SF-12 or EQ-5D did not. CONCLUSIONS: The Korean version of QUALEFFO-41 demonstrated relevant internal consistency, convergent validity, and discriminant validity, which can be recommended to evaluate quality of life in Koreans.