Original Article

Osteoporosis International

, Volume 22, Issue 1, pp 27-35

Open Access This content is freely available online to anyone, anywhere at any time.

Failure to perceive increased risk of fracture in women 55 years and older: the Global Longitudinal Study of Osteoporosis in Women (GLOW)

  • E. S. SirisAffiliated withDepartment of Medicine, Columbia University Medical Center Email author 
  • , S. GehlbachAffiliated withCenter for Outcomes Research, UMASS Medical School
  • , J. D. AdachiAffiliated withSt. Joseph’s Hospital, McMaster University
  • , S. BoonenAffiliated withLeuven University Center for Metabolic Bone Diseases, Division of Geriatric Medicine, Katholieke Universiteit Leuven
  • , R. D. ChapurlatAffiliated withDivision of Rheumatology, Hôpital E. Herriot, INSERM U831, Université de Lyon
  • , J. E. CompstonAffiliated withSchool of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge
  • , C. CooperAffiliated withMRC Epidemiology Resource Centre, University of Southampton, Southampton General HospitalInstitute of Musculoskeletal Sciences, University of Oxford
  • , P. DelmasAffiliated withDivision of Rheumatology, Hôpital E. Herriot, INSERM U831, Université de Lyon
  • , A. Díez-PérezAffiliated withDepartment of Medicine, Hospital del Mar-IMIM-Autonomous, University of Barcelona
    • , F. H. HoovenAffiliated withCenter for Outcomes Research, UMASS Medical School
    • , A. Z. LaCroixAffiliated withDepartment of Medicine, Columbia University Medical CenterFred Hutchinson Cancer Research Center
    • , J. C. NetelenbosAffiliated withDepartment of Medicine, Columbia University Medical CenterDepartment of Endocrinology, VU University Medical Center
    • , J. PfeilschifterAffiliated withDepartment of Medicine, Columbia University Medical CenterDepartment of Internal Medicine III, Alfried Krupp Krankenhaus
    • , M. RossiniAffiliated withDepartment of Medicine, Columbia University Medical CenterDepartment of Rheumatology, University of Verona
    • , C. RouxAffiliated withDepartment of Medicine, Columbia University Medical CenterParis Descartes University, Cochin Hospital
    • , K. G. SaagAffiliated withDepartment of Medicine, Columbia University Medical CenterUniversity of Alabama-Birmingham
    • , P. SambrookAffiliated withDepartment of Medicine, Columbia University Medical CenterUniversity of Sydney-Royal North Shore Hospital, St. Leonards
    • , S. SilvermanAffiliated withDepartment of Medicine, Columbia University Medical CenterDepartment of Rheumatology, Cedars-Sinai/UCLA
    • , N. B. WattsAffiliated withDepartment of Medicine, Columbia University Medical CenterBone Health and Osteoporosis Center, University of Cincinnati
    • , A. WymanAffiliated withCenter for Outcomes Research, UMASS Medical School
    • , S. L. GreenspanAffiliated withDepartment of Medicine, Columbia University Medical CenterUniversity of Pittsburgh

Abstract

Summary

We compared self-perception of fracture risk with actual risk among 60,393 postmenopausal women aged ≥55 years, using data from the Global Longitudinal Study of Osteoporosis in Women (GLOW). Most postmenopausal women with risk factors failed to appreciate their actual risk for fracture. Improved education about osteoporosis risk factors is needed.

Introduction

This study seeks to compare self-perception of fracture risk with actual risk among postmenopausal women using data from GLOW.

Methods

GLOW is an international, observational, cohort study involving 723 physician practices in 17 sites in ten countries in Europe, North America, and Australia. Participants included 60,393 women ≥55 years attended by their physician during the previous 24 months. The sample was enriched so that two thirds were ≥65 years. Baseline surveys were mailed October 2006 to February 2008. Main outcome measures were self-perception of fracture risk in women with elevated risk vs women of the same age and frequency of risk factors for fragility fracture.

Results

In the overall study population, 19% (10,951/58,434) of women rated their risk of fracture as a little/much higher than that of women of the same age; 46% (27,138/58,434) said it was similar; 35% (20,345/58,434) believed it to be a little/much lower. Among women whose actual risk was increased based on the presence of any one of seven risk factors for fracture, the proportion who recognized their increased risk ranged from 19% for smokers to 39% for current users of glucocorticoid medication. Only 33% (4,185/12,612) of those with ≥2 risk factors perceived themselves as being at higher risk. Among women reporting a diagnosis of osteopenia or osteoporosis, only 25% and 43%, respectively, thought their risk was increased.

Conclusion

In this international, observational study, most postmenopausal women with risk factors failed to appreciate their actual risk for fracture.

Keywords

Osteoporosis Postmenopausal Risk factor Women