Abstract
Summary
To clarify the contribution of osteoporosis to future immobilization, a prospective observational study was carried out on Japanese postmenopausal women. The prevalence of low bone mineral density (BMD) and vertebral fracture were independent risks for future immobilization.
Introduction
Immobilization by hip fracture requires more medical care and higher costs. Osteoporosis increases the risk of hip fracture, but there is little data linking osteoporosis and immobilization in postmenopausal Japanese women.
Methods
The study participants consisted of postmenopausal ambulatory volunteers. Baseline information such as BMD, prevalent fractures, comorbidities, pain in the body, and variables were obtained from 1993, and time course of occurrence of immobilization was observed until 2008.
Results
A total of 1,312 participants were enrolled and were observed for a total of 6.7 ± 4.1 years. A total of 75 subjects suffered immobilization. In multivariate analysis to calculate the Cox’s hazard ratio of baseline parameters for immobilization, four independent variables were observed: age (hazard ratio, 1.52 [95% CI, 1.29 to 1.80], p = 0.000), pain in the body (2.54 [1.42 to 4.89, p = 0.001]), low BMD (1.83 [1.10 to 3.13, p = 0.020]), and dementia (3.58 [91.80 to 6.76, p = 0.001]). The hazard ratio of prevalent vertebral fracture was 1.98 (1.20 to 3.30, p = 0.007) instead of low BMD of above model.
Conclusion
These results indicate that low BMD and prevalent vertebral fracture pose an independent risk for future immobilization in postmenopausal Japanese women.
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References
Iijima S (2008) Situation of the long-term care insurance system. Jpn J Geriatrics 45:377–380 In Japanese
Harada A, Matsui Y, Takemura M, Ito Z, Wakao N, Ota T (2005) Cost-utility analysis of osteoporosis. Jpn J Geriat 16:6–14 In Japanese
Cabinet Office, Government of Japan (2004) White Paper on the National Lifestyle 2004 A comfortable way of life for the Japanese people, founded on personal relationships
Okie S (2008) Home delivery—bringing primary care to housebound elderly. New Engl J Med 359:2409–2412
NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy (2001) Osteoporosis prevention, diagnosis, and therapy. JAMA 285:785–795
Hannan EL, Magaziner J, Wang JJ, Eastwood EA, Silberzweig SB, Gilbert M, Morrison RS, McLaughlin MA, Orosz GM, Siu AL (2001) Mortality and locomotion 6 months after hospitalization for hip fractures: risk factors and risk-adjusted hospital outcomes. JAMA 285:2736–2742
Siu AL, Penrod JD, Boockvar KS, Koval K, Strauss E, Morrison RS (2006) Early ambulation after hip fracture: effects on function and mortality. Arch Intern Med 166:766–771
Johnell O, Kanis JA, Oden A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jonsson B (2004) Mortality after osteoporotic fractures. Osteoporos Int 15(1):38–42
Ensrud KE, Thompson DE, Cauley JA, Nevitt MC, Kado DM, Hochberg MC, Santora AC, Black DM (2000) Prevalent vertebral deformities predict mortality and hospitalization in older women with low bone mass. Fracture intervention trial research group. J Am Geriatr Soc 48(3):241–249
Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353(9156):878–882
Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR (1999) Vertebral fractures and mortality in older women: a prospective study. Study of osteoporotic fractures research group. Arch Intern Med 159(11):1215–1220
Kuroda T, Shiraki M, Tanaka S, Ohta H (2009) Contributions of 25-hydroxyvitamin D, co-morbidities and bone mass to mortality in Japanese postmenopausal women. Bone 44:168–172
Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324
Shiraki M, Shiraki Y, Aoki C, Hosoi T, Inoue S, Kaneki M, Ouchi Y (1997) Association of bone mineral density with apolipoprotein E phenotype. J Bone Miner Res 12:1438–1445
Orimo H, Hayashi Y, Fukunaga M, Sone T, Fujiwara S, Shiraki M, Kushida K, Miyamoto S, Soen S, Nishimura J, Ohashi Y, Hosoi T, Gorai I, Tanaka H, Igai T, Kishimoto H (2001) Osteoporosis Diagnostic Criteria Review Committee: Japanese Society for Bone and Mineral Research. Diagnostic criteria for primary osteoporosis: year 2000 revision. J Bone Miner Metab 19:331–337
Genant HK, Jergas M, Palermo L, Nevitt M, Valentin RS, Black D, Cummings SR (1996) Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis. The study of Osteoporotic Fractures Research Group. J Bone Miner Res 11:984–996
Shiraki M, Kuroda T, Nakamura T, Fukunaga M, Hosoi T, Orimo H, Makino K (2006) The sample size required for intervention studies on fracture prevention can be decreased by using a bone resorption marker in the inclusion criteria: prospective study of a subset of the Nagano Cohort, on behalf of the Adequate Treatment of Osteoporosis (A-TOP) Research Group. J Bone Miner Metab 24:219–225
Shiraki M, Kuroda T, Tanaka S, Saito M, Fukunaga M, Nakamura T (2008) Nonenzymatic collagen cross-links induced by glycoxidation (pentosidine) predicts vertebral fractures. J Bone Miner Metab 26:93–100
Hagino H, Nakamura T, Fujiwara S, Oeki M, Okano T, Teshima R (2009) Sequential change in quality of life for patients with incident clinical fractures: a prospective study. Osteoporosis Int 20(5):695–702
Cockerill W, Lunt M, Silman AJ, Cooper C, Lips P, Bhalla AK, Cannata JB, Eastell R, Felsenberg D, Gennari C, Johnell O, Kanis JA, Kiss C, Masaryk P, Naves M, Poor G, Raspe H, Reid DM, Reeve J, Stepan J, Todd C, Woolf AD, O’Neill TW (2004) Health-related quality of life and radiographic vertebral fracture. Osteoporos Int 15(2):113–119
Brenneman SK, Barrett-Connor E, Sajjan S, Markson LE, Siris ES (2006) Impact of recent fracture on health-related quality of life in postmenopausal women. J Bone Miner Res 21(6):809–816
Miller CW (1978) Survival and ambulation following hip fracture. J Bone Joint Surg Am 60(7):930–934
Borgquist L, Ceder L, Thorngren KG (1990) Function and social status 10 years after hip fracture. Prospective follow-up of 103 patients. Acta Orthop Scand 61(5):404–410
Keene GS, Parker MJ, Pryor GA (1993) Mortality and morbidity after hip fractures. BMJ 307(6914):1248–1250
Kitamura S, Hasegawa Y, Suzuki S, Sasaki R, Iwata H, Wingstrand H, Thorngren KG (1998) Functional outcome after hip fracture in Japan. Clin Orthop Relat Res 348:29–36
Cotter VT (2007) The burden of dementia. Am J Manag Care Suppl 8:S193–S197
Nevitt MC, Thompson DE, Black DM, Rubin SR, Ensrud K, Yates AJ, Cummings SR (2000) Effect of alendronate on limited-activity days and bed-disability days caused by back pain in postmenopausal women with existing vertebral fractures. Fracture Intervention Trial Research Group. Arch Intern Med 160(1):77–85
Knopp JA, Diner BM, Blitz M, Lyritis GP, Rowe BH (2005) Calcitonin for treating acute pain of osteoporotic vertebral compression fractures: a systematic review of randomized, controlled trials. Osteoporos Int 16(10):1281–1290
Nevitt MC, Chen P, Dore RK, Reginster JY, Kiel DP, Zanchetta JR, Glass EV, Krege JH (2006) Reduced risk of back pain following teriparatide treatment: a meta-analysis. Osteoporos Int 17(2):273–280
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Shiraki, M., Kuroda, T., Shiraki, Y. et al. Effects of bone mineral density of the lumbar spine and prevalent vertebral fractures on the risk of immobility. Osteoporos Int 21, 1545–1551 (2010). https://doi.org/10.1007/s00198-009-1121-9
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DOI: https://doi.org/10.1007/s00198-009-1121-9