Multidimensional prognostic index and the risk of fractures: an 8-year longitudinal cohort study in the Osteoarthritis Initiative
Multidimensional prognostic index and the risk of fractures: an 8-year longitudinal cohort study in the Osteoarthritis Initiative
Summary: In this longitudinal study, with a follow-up of 8 years, multidimensional prognostic index (MPI), a product of the comprehensive geriatric assessment, significantly predicted the onset of fractures in older people affected by knee osteoarthritis. Purpose: Frailty may be associated with higher fracture risk, but limited research has been carried out using a multidimensional approach to frailty assessment and diagnosis. The present research aimed to investigate whether the MPI, based on comprehensive geriatric assessment (CGA), is associated with the risk of fractures in the Osteoarthritis Initiative (OAI) study. Methods: Community-dwellers affected by knee OA or at high risk for this condition were followed-up for 8 years. A standardized CGA including information on functional, nutritional, mood, comorbidity, medication, quality of life, and co-habitation status was used to calculate the MPI. Fractures were diagnosed using self-reported information. Cox’s regression analysis was carried out and results are reported as hazard ratios (HRs), with their 95% confidence intervals (CIs), adjusted for potential confounders. Results: The sample consisted of 4024 individuals (mean age 61.0 years, females = 59.0%). People with incident fractures had a significant higher MPI baseline value than those without (0.42 ± 0.18 vs. 0.40 ± 0.17). After adjusting for several potential confounders, people with an MPI over 0.66 (HR = 1.49; 95%CI: 1.11–2.00) experienced a higher risk of fractures. An increase in 0.10 point in MPI score corresponded to an increase in fracture risk of 4% (HR = 1.04; 95%CI: 1.008–1.07). Higher MPI values were also associated with a higher risk of non-vertebral clinical fractures. Conclusion: Higher MPI values at baseline were associated with an increased risk of fractures, reinforcing the importance of CGA in predicting fractures in older people affected by knee OA.
Comprehensive geriatric assessment, Fractures, Multidimensional prognostic index, Osteoarthritis Initiative
Veronese, Nicola
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Smith, Lee
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Zigoura, Ekaterini
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Barbagallo, Mario
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Dominguez, Ligia J.
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Barone, Antonella
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Cella, Alberto
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Cooper, Cyrus
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Rizzoli, René
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Reginster, Jean Yves
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Maggi, Stefania
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Pilotto, Alberto
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14 December 2021
Veronese, Nicola
c4539c05-e941-46d2-8683-b7c9dc09b211
Smith, Lee
c8de081c-81c6-4825-aaa6-154ebcf2eeea
Zigoura, Ekaterini
b8da87ad-ca97-4e27-8f9d-be133c820ddd
Barbagallo, Mario
253443e1-cdf1-4549-ac04-c18c27d11d1a
Dominguez, Ligia J.
5d89a3bd-a08c-4f16-a7af-2e5d33ebc49d
Barone, Antonella
4c1346ce-cfd5-4312-9cc3-9c4b892722fb
Cella, Alberto
ce31d7ec-67da-4b14-be6a-10c48c721e4b
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Rizzoli, René
c1190577-8164-471d-b90f-6959f92bc25e
Reginster, Jean Yves
33684a35-87f7-4b8d-bb91-4da2b809f855
Maggi, Stefania
57e7e62a-b7dd-4291-82e3-efc8c9a7e12a
Pilotto, Alberto
b81d73ea-1c69-40a7-bb2d-a1bcc9c91c49
Veronese, Nicola, Smith, Lee, Zigoura, Ekaterini, Barbagallo, Mario, Dominguez, Ligia J., Barone, Antonella, Cella, Alberto, Cooper, Cyrus, Rizzoli, René, Reginster, Jean Yves, Maggi, Stefania and Pilotto, Alberto
(2021)
Multidimensional prognostic index and the risk of fractures: an 8-year longitudinal cohort study in the Osteoarthritis Initiative.
Archives of Osteoporosis, 17 (1), [5].
(doi:10.1007/s11657-021-01015-3).
Abstract
Summary: In this longitudinal study, with a follow-up of 8 years, multidimensional prognostic index (MPI), a product of the comprehensive geriatric assessment, significantly predicted the onset of fractures in older people affected by knee osteoarthritis. Purpose: Frailty may be associated with higher fracture risk, but limited research has been carried out using a multidimensional approach to frailty assessment and diagnosis. The present research aimed to investigate whether the MPI, based on comprehensive geriatric assessment (CGA), is associated with the risk of fractures in the Osteoarthritis Initiative (OAI) study. Methods: Community-dwellers affected by knee OA or at high risk for this condition were followed-up for 8 years. A standardized CGA including information on functional, nutritional, mood, comorbidity, medication, quality of life, and co-habitation status was used to calculate the MPI. Fractures were diagnosed using self-reported information. Cox’s regression analysis was carried out and results are reported as hazard ratios (HRs), with their 95% confidence intervals (CIs), adjusted for potential confounders. Results: The sample consisted of 4024 individuals (mean age 61.0 years, females = 59.0%). People with incident fractures had a significant higher MPI baseline value than those without (0.42 ± 0.18 vs. 0.40 ± 0.17). After adjusting for several potential confounders, people with an MPI over 0.66 (HR = 1.49; 95%CI: 1.11–2.00) experienced a higher risk of fractures. An increase in 0.10 point in MPI score corresponded to an increase in fracture risk of 4% (HR = 1.04; 95%CI: 1.008–1.07). Higher MPI values were also associated with a higher risk of non-vertebral clinical fractures. Conclusion: Higher MPI values at baseline were associated with an increased risk of fractures, reinforcing the importance of CGA in predicting fractures in older people affected by knee OA.
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Accepted/In Press date: 27 September 2021
Published date: 14 December 2021
Additional Information:
Funding Information:
The OAI is a public–private partnership comprising five contracts (N01-AR-2–2258; N01-AR-2–2259; N01-AR-2–2260; N01-AR-2–2261; N01-AR-2–2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This manuscript was prepared using an OAI public use data set and does not necessarily reflect the opinions or views of the OAI investigators, the NIH, or the private funding partners.
Publisher Copyright:
© 2021, The Author(s).
Keywords:
Comprehensive geriatric assessment, Fractures, Multidimensional prognostic index, Osteoarthritis Initiative
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Local EPrints ID: 453286
URI: http://eprints.soton.ac.uk/id/eprint/453286
ISSN: 1862-3522
PURE UUID: 4954f307-03fa-4617-924e-65c244970e59
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Date deposited: 12 Jan 2022 17:33
Last modified: 18 Mar 2024 05:07
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Contributors
Author:
Nicola Veronese
Author:
Lee Smith
Author:
Ekaterini Zigoura
Author:
Mario Barbagallo
Author:
Ligia J. Dominguez
Author:
Antonella Barone
Author:
Alberto Cella
Author:
René Rizzoli
Author:
Jean Yves Reginster
Author:
Stefania Maggi
Author:
Alberto Pilotto
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