Osteoporosis International

, Volume 20, Issue 5, pp 703–714

The impact of incident fractures on health-related quality of life: 5 years of data from the Canadian Multicentre Osteoporosis Study


    • McMaster University, Hamilton Health Sciences—Chedoke Site
    • McMaster University
  • C. C. Kennedy
    • McMaster University
  • G. Ioannidis
    • McMaster University
    • St. Joseph’s Hospital
  • A. Sawka
    • University of Toronto
  • W. M. Hopman
    • Queen’s University
  • L. Pickard
    • McMaster University
    • St. Joseph’s Hospital
  • J. P. Brown
    • Laval University
  • R. G. Josse
    • University of Toronto
  • S. Kaiser
    • Dalhousie University
  • T. Anastassiades
    • Queen’s University
  • D. Goltzman
    • McGill University
  • M. Papadimitropoulos
    • University of Toronto
    • Eli Lilly and Company
  • A. Tenenhouse
    • McGill University
  • J. C. Prior
    • University of British Columbia
  • W. P. Olszynski
    • University of Saskatchewan
  • J. D. Adachi
    • McMaster University
    • St. Joseph’s Hospital
  • for the CaMos Study Group
Original Article

DOI: 10.1007/s00198-008-0743-7

Cite this article as:
Papaioannou, A., Kennedy, C.C., Ioannidis, G. et al. Osteoporos Int (2009) 20: 703. doi:10.1007/s00198-008-0743-7



Using prospective data from the Canadian Multicentre Osteoporosis Study (CaMos), we compared health utilities index (HUI) scores after 5 years of follow-up among participants (50 years and older) with and without incident clinical fractures. Incident fractures had a negative impact on HUI scores over time.


This study examined change in health-related quality of life (HRQL) in those with and without incident clinical fractures as measured by the HUI.


The study cohort was 4,820 women and 1,783 men (50 years and older) from the CaMos. The HUI was administered at baseline and year 5. Participants were sub-divided into incident fracture groups (hip, rib, spine, forearm, pelvis, other) and were compared with those without these fractures. The effects of both time and fracture type on HUI scores were examined in multivariable regression analyses.


Men and women with hip fractures, compared to those without, had lower HUI measures that ranged from −0.05 to −0.25. Both women and men with spine fractures had significant deficits on the pain attributes (−0.07 to −0.12). In women, self-care (−0.06), mobility and ambulation (−0.05) were also negatively impacted. Women with rib fractures had deficits similar to women with spine fractures, and these effects persisted over time. In men, rib fractures did not significantly affect HUI scores. Pelvic and forearm fractures did not substantially influence HUI scores.


The HUI was a sensitive measure of HRQL change over time. These results will inform economic analyses evaluating osteoporosis therapies.


Cost–utilityEpidemiologyFracturesHealth utilities indexOsteoporosisQuality of life

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2008