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An increased rate of falling leads to a rise in fracture risk in postmenopausal women with self-reported osteoarthritis: a prospective multinational cohort study (GLOW)

An increased rate of falling leads to a rise in fracture risk in postmenopausal women with self-reported osteoarthritis: a prospective multinational cohort study (GLOW)
An increased rate of falling leads to a rise in fracture risk in postmenopausal women with self-reported osteoarthritis: a prospective multinational cohort study (GLOW)
Objectives: Patients with osteoarthritis have increased bone mass but no decrease in fractures. The association between self-reported osteoarthritis and incident falls and fractures was studied in postmenopausal women.

Methods: The Global Longitudinal Study of Osteoporosis in Women is a prospective multinational cohort of 60?393 non-institutionalised women aged ?55?years who had visited primary care practices within the previous 2?years. Questionnaires were mailed at yearly intervals. Patients were classified as having osteoarthritis if they answered yes to the question, ‘Has a doctor or other health provider ever said that you had osteoarthritis or degenerative joint disease?’, and this was validated against primary care records in a subsample. Information on incident falls, fractures and covariates was self-reported. Cox and Poisson models were used for incident fractures and number of falls, respectively, to compute hazard ratios (HRs) and rate ratios (RRs) for baseline osteoarthritis status.

Results: Of 51?386 women followed for a median of 2.9?years (interquartile range 2.1–3.0), 20?409 (40%) reported osteoarthritis. The adjusted HR for osteoarthritis predicting fracture was 1.21 (95% CI 1.13 to 1.30; p<0.0001) and the adjusted RR for falls was 1.24 (95% CI 1.22 to 1.26; p<0.0001). However, the association between osteoarthritis and fracture was not significant after adjustment for incident falls (HR 1.06 (95% CI 0.98 to 1.15; p=0.13)).

Conclusions: Postmenopausal women with self-reported osteoarthritis have a 20% increased risk of fracture and experience 25% more falls than those without osteoarthritis. These data suggest that increased falls are the causal pathway of the association between osteoarthritis and fractures.
0003-4967
911-917
Prieto-Alhambra, Daniel
e596722a-2f01-4201-bd9d-be3e180e76a9
Nogues, Xavier
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Javaid, M. Kassim
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Wyman, Allison
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Arden, N igelK.
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Azagra, Rafael
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Cooper, Cyrus
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Adachi, Jonathan D.
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Boonen, Steven
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Chapurlat, Roland D.
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Compston, Juliet E.
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Gehlbach, Stephen H.
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Greenspan, Susan L.
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Hooven, Frederick H.
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Netelenbos, J.Coen
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Pfeilschifter, Johannes
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Rossini, Maurizio
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Sambrook, Philip N.
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Silverman, Stuart
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Siris, Ethel S.
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Watts, Nelson B.
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Diez-Perez, Adolfo
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Prieto-Alhambra, Daniel
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Nogues, Xavier
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Javaid, M. Kassim
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Wyman, Allison
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Arden, N igelK.
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Azagra, Rafael
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Cooper, Cyrus
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Adachi, Jonathan D.
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Boonen, Steven
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Chapurlat, Roland D.
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Compston, Juliet E.
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Gehlbach, Stephen H.
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Greenspan, Susan L.
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Hooven, Frederick H.
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Netelenbos, J.Coen
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Pfeilschifter, Johannes
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Rossini, Maurizio
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Sambrook, Philip N.
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Silverman, Stuart
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Siris, Ethel S.
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Watts, Nelson B.
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Diez-Perez, Adolfo
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Prieto-Alhambra, Daniel, Nogues, Xavier, Javaid, M. Kassim, Wyman, Allison, Arden, N igelK., Azagra, Rafael, Cooper, Cyrus, Adachi, Jonathan D., Boonen, Steven, Chapurlat, Roland D., Compston, Juliet E., Gehlbach, Stephen H., Greenspan, Susan L., Hooven, Frederick H., Netelenbos, J.Coen, Pfeilschifter, Johannes, Rossini, Maurizio, Sambrook, Philip N., Silverman, Stuart, Siris, Ethel S., Watts, Nelson B. and Diez-Perez, Adolfo (2013) An increased rate of falling leads to a rise in fracture risk in postmenopausal women with self-reported osteoarthritis: a prospective multinational cohort study (GLOW). Annals of the Rheumatic Diseases, 72 (6), 911-917. (doi:10.1136/annrheumdis-2012-201451). (PMID:22730372)

Record type: Article

Abstract

Objectives: Patients with osteoarthritis have increased bone mass but no decrease in fractures. The association between self-reported osteoarthritis and incident falls and fractures was studied in postmenopausal women.

Methods: The Global Longitudinal Study of Osteoporosis in Women is a prospective multinational cohort of 60?393 non-institutionalised women aged ?55?years who had visited primary care practices within the previous 2?years. Questionnaires were mailed at yearly intervals. Patients were classified as having osteoarthritis if they answered yes to the question, ‘Has a doctor or other health provider ever said that you had osteoarthritis or degenerative joint disease?’, and this was validated against primary care records in a subsample. Information on incident falls, fractures and covariates was self-reported. Cox and Poisson models were used for incident fractures and number of falls, respectively, to compute hazard ratios (HRs) and rate ratios (RRs) for baseline osteoarthritis status.

Results: Of 51?386 women followed for a median of 2.9?years (interquartile range 2.1–3.0), 20?409 (40%) reported osteoarthritis. The adjusted HR for osteoarthritis predicting fracture was 1.21 (95% CI 1.13 to 1.30; p<0.0001) and the adjusted RR for falls was 1.24 (95% CI 1.22 to 1.26; p<0.0001). However, the association between osteoarthritis and fracture was not significant after adjustment for incident falls (HR 1.06 (95% CI 0.98 to 1.15; p=0.13)).

Conclusions: Postmenopausal women with self-reported osteoarthritis have a 20% increased risk of fracture and experience 25% more falls than those without osteoarthritis. These data suggest that increased falls are the causal pathway of the association between osteoarthritis and fractures.

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e-pub ahead of print date: 23 June 2013
Published date: June 2013
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 355768
URI: http://eprints.soton.ac.uk/id/eprint/355768
ISSN: 0003-4967
PURE UUID: 4d09b0e5-2639-4d10-90d9-10b7bddf5a7f
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 04 Sep 2013 13:12
Last modified: 10 Dec 2019 01:53

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Contributors

Author: Daniel Prieto-Alhambra
Author: Xavier Nogues
Author: M. Kassim Javaid
Author: Allison Wyman
Author: N igelK. Arden
Author: Rafael Azagra
Author: Cyrus Cooper ORCID iD
Author: Jonathan D. Adachi
Author: Steven Boonen
Author: Roland D. Chapurlat
Author: Juliet E. Compston
Author: Stephen H. Gehlbach
Author: Susan L. Greenspan
Author: Frederick H. Hooven
Author: J.Coen Netelenbos
Author: Johannes Pfeilschifter
Author: Maurizio Rossini
Author: Philip N. Sambrook
Author: Stuart Silverman
Author: Ethel S. Siris
Author: Nelson B. Watts
Author: Adolfo Diez-Perez

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