Original Article

Osteoporosis International

, Volume 20, Issue 5, pp 703-714

First online:

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

  • A. PapaioannouAffiliated withMcMaster University, Hamilton Health Sciences—Chedoke SiteMcMaster University Email author 
  • , C. C. KennedyAffiliated withMcMaster University
  • , G. IoannidisAffiliated withMcMaster UniversitySt. Joseph’s Hospital
  • , A. SawkaAffiliated withUniversity of Toronto
  • , W. M. HopmanAffiliated withQueen’s University
  • , L. PickardAffiliated withMcMaster UniversitySt. Joseph’s Hospital
  • , J. P. BrownAffiliated withLaval University
  • , R. G. JosseAffiliated withUniversity of Toronto
  • , S. KaiserAffiliated withDalhousie University
    • , T. AnastassiadesAffiliated withQueen’s University
    • , D. GoltzmanAffiliated withMcGill University
    • , M. PapadimitropoulosAffiliated withUniversity of TorontoEli Lilly and Company
    • , A. TenenhouseAffiliated withMcGill University
    • , J. C. PriorAffiliated withUniversity of British Columbia
    • , W. P. OlszynskiAffiliated withUniversity of Saskatchewan
    • , J. D. AdachiAffiliated withMcMaster UniversitySt. Joseph’s Hospital
    • , for the CaMos Study Group

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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–utility Epidemiology Fractures Health utilities index Osteoporosis Quality of life