Advertisement

Osteoporosis International

, Volume 16, Issue 7, pp 749–756 | Cite as

Impact of vertebral deformities, osteoarthritis, and other chronic diseases on quality of life: a population-based study

  • N. M. van SchoorEmail author
  • J. H. Smit
  • J. W. R. Twisk
  • P. Lips
Original Article

Abstract

Vertebral deformities and spinal osteoarthritis are common disorders in elderly persons and are associated with back pain, impaired physical functioning, and loss of quality of life. The objectives of this study were to assess the impact of vertebral deformities and osteoarthritis on quality of life in a population-based sample, and to compare this with the impact of six other important chronic diseases on quality of life. The study was performed as a substudy of the Longitudinal Aging Study Amsterdam. Vertebral deformities and osteoarthritis were assessed by spinal radiographs; chronic diseases were assessed by self-report; quality of life was estimated by the SF-12, EQ-5D (EuroQol) and Qualeffo-41 (n=336). In univariate analyses, severe osteoporosis of the vertebrae significantly worsened the physical component summary scale of the SF-12 and the total score of Qualeffo-41, while osteoarthritis of the spine did not significantly reduce quality of life. The other chronic diseases reduced quality of life, although not all changes reached statistical significance. In multivariate analyses, severe osteoporosis of the vertebrae, cardiac disease, peripheral arterial disease, and diabetes mellitus significantly reduced quality of life. In conclusion, most persons in an elderly population suffer from one or more chronic diseases, and therefore experience loss of quality of life. After adjustment for age, sex, and other chronic diseases, severe osteoporosis of the vertebrae, cardiac disease, peripheral arterial disease, and diabetes mellitus significantly reduced quality of life in the general population.

Keywords

Chronic diseases Elderly Quality of life Spinal osteoarthritis Vertebral deformities 

Notes

Acknowledgements. This study was based on data collected within the framework of the Longitudinal Aging Study Amsterdam (LASA), which is funded by the Ministry of Health, Welfare, and Sports of The Netherlands. N. van Schoor was funded by a grant from Wyeth Research, Collegeville, Pennsylvania.

References

  1. 1.
    Hasserius R, Redlund-Johnell I, Mellstrom D, Johansson C, Nilsson BE, Johnell O (2001) Vertebral deformation in urban Swedish men and women: prevalence based on 797 subjects. Acta Orthop Scand 72:273–278CrossRefPubMedGoogle Scholar
  2. 2.
    Jones G, White C, Nguyen T, Sambrook PN, Kelly PJ, Eisman JA (1996) Prevalent vertebral deformities: relationship to bone mineral density and spinal osteophytosis in elderly men and women. Osteoporos Int 6:233–239PubMedGoogle Scholar
  3. 3.
    Lau EMC, Woo J, Chan H, Chan MKF, Griffith J, Chan YH et al. (1998) The health consequences of vertebral deformity in elderly Chinese men and women. Calcif Tissue Int 63:1–4CrossRefPubMedGoogle Scholar
  4. 4.
    Melton LJ III, Lane AW, Cooper C, Eastell R, O’Fallon WM, Riggs BL (1993) Prevalence and incidence of vertebral deformities. Osteoporos Int 3:113–119PubMedGoogle Scholar
  5. 5.
    Pluijm SM, Tromp AM, Smit JH, Deeg DJ, Lips P (2000) Consequences of vertebral deformities in older men and women. J Bone Miner Res 15:1564–1572PubMedGoogle Scholar
  6. 6.
    Silverman SL (1992) The clinical consequences of vertebral compression fracture. Bone 13 (Suppl 2):S27–S31CrossRefPubMedGoogle Scholar
  7. 7.
    Pluijm SM, van Essen HW, Bravenboer N, Uitterlinden AG, Smit JH, Pols HA et al. (2004) Collagen type I alpha1 Sp1 polymorphism, osteoporosis, and intervertebral disc degeneration in older men and women. Ann Rheum Dis 63:71–77CrossRefPubMedGoogle Scholar
  8. 8.
    O’Neill TW, McCloskey EV, Kanis JA, Bhalla AK, Reeve J, Reid DM et al. (1999) The distribution, determinants, and clinical correlates of vertebral osteophytosis: a population based survey. J Rheumatol 26:842–848PubMedGoogle Scholar
  9. 9.
    Paiva LC, Filardi S, Pinto-Neto AM, Samara A, Marques Neto JF (2002) Impact of degenerative radiographic abnormalities and vertebral fractures on spinal bone density of women with osteoporosis. Sao Paulo Med J 120:9–12PubMedGoogle Scholar
  10. 10.
    Adachi JD, Loannidis G, Berger C, Joseph L, Papaioannou A, Pickard L et al. (2001) The influence of osteoporotic fractures on health-related quality of life in community-dwelling men and women across Canada. Osteoporos Int 12:903–908CrossRefPubMedGoogle Scholar
  11. 11.
    Borenstein D (2004) Does osteoarthritis of the lumbar spine cause chronic low back pain? Curr Rheumatol Rep 6:14–19PubMedGoogle Scholar
  12. 12.
    Cockerill W, Lunt M, Silman AJ, Cooper C, Lips P, Bhalla AK et al. (2004) Health-related quality of life and radiographic vertebral fracture. Osteoporos Int 15:113–119CrossRefPubMedGoogle Scholar
  13. 13.
    Hall SE, Criddle RA, Comito TL, Prince RL (1999) A case-control study of quality of life and functional impairment in women with long-standing vertebral osteoporotic fracture. Osteoporos Int 9:508–515CrossRefPubMedGoogle Scholar
  14. 14.
    Lips P, Cooper C, Agnusdei D, Caulin F, Egger P, Johnell O et al. (1999) Quality of life in patients with vertebral fractures. Validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Osteoporos Int 10:150–160CrossRefPubMedGoogle Scholar
  15. 15.
    Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C et al. (2000) Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res 15:1384–1392PubMedGoogle Scholar
  16. 16.
    Ross PD (1997) Clinical consequences of vertebral fractures. Am J Med 103:30S-42SPubMedGoogle Scholar
  17. 17.
    Silverman SL, Minshall ME, Shen W, Harper KD, Xie S (2001) The relationship of health-related quality of life to prevalent and incident vertebral fractures in postmenopausal women with osteoporosis: results from the Multiple Outcomes of Raloxifene Evaluation Study. Arthritis Rheum 44:2611–2619CrossRefPubMedGoogle Scholar
  18. 18.
    Tosteson AN, Gabriel SE, Grove MR, Moncur MM, Kneeland TS, Melton LJ (2001) Impact of hip and vertebral fractures on quality-adjusted life years. Osteoporos Int 12:1042–1049CrossRefPubMedGoogle Scholar
  19. 19.
    Ross PD, Davis JW, Epstein RS, Wasnich RD (1994) Pain and disability associated with new vertebral fractures and other spinal conditions. J Clin Epidemiol 47:231–239CrossRefPubMedGoogle Scholar
  20. 20.
    Naves M, Diaz-Lopez JB, Gomez C, Rodriguez-Rebollar A, Rodriguez-Garcia M, Cannata-Andia JB (2003) The effect of vertebral fracture as a risk factor for osteoporotic fracture and mortality in a Spanish population. Osteoporos Int 14:520–524Google Scholar
  21. 21.
    Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB et al. (2001) Risk of new vertebral fracture in the year following a fracture. J Am Med Assoc 285:320–323CrossRefGoogle Scholar
  22. 22.
    Johnell O, Oden A, Caulin F, Kanis JA (2001) Acute and long-term increase in fracture risk after hospitalization for vertebral fracture. Osteoporos Int 12:207–214CrossRefPubMedGoogle Scholar
  23. 23.
    Cooper C, Atkinson EJ, Jacobsen SJ, O’Fallon WM, Melton LJ (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005PubMedGoogle Scholar
  24. 24.
    Kado DM, Duong T, Stone KL, Ensrud KE, Nevitt MC, Greendale GA et al. (2003) Incident vertebral fractures and mortality in older women: a prospective study. Osteoporos Int 14:589–594Google Scholar
  25. 25.
    Christodoulou C, Cooper C (2003) What is osteoporosis? Postgrad Med J 79:133–138CrossRefPubMedGoogle Scholar
  26. 26.
    Cooper C, Atkinson EJ, O’Fallon WM, Melton LJ III (1992) Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 7:221–227PubMedGoogle Scholar
  27. 27.
    Nevitt MC, Ettinger B, Black DM, Stone K, Jamal SA, Ensrud K et al. (1998) The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med 128:793–800PubMedGoogle Scholar
  28. 28.
    van Staa TP, Dennison EM, Leufkens HG, Cooper C (2001) Epidemiology of fractures in England and Wales. Bone 29:517–522CrossRefPubMedGoogle Scholar
  29. 29.
    Deeg DJH, Westendorp-de Seriere M (1994) Autonomy and well-being in the aging population. I: Report from the Longitudinal Aging Study Amsterdam 1992–1993. VU University Press, AmsterdamGoogle Scholar
  30. 30.
    Ware JE, Kosinski M, Keller SD. SF-12 (1995) How to score the SF-12 Physical and Mental Health Summary Scales. The Health Institute, New England Medical Center, Boston, MassachusettsGoogle Scholar
  31. 31.
    Brooks R, Rabin R, Charro F de (eds) (2003) The measurement and valuation of health status using EQ-5D: a European perspective. Kluwer Academic Publishers, DordrechtGoogle Scholar
  32. 32.
    Dolan P (1997) Modeling valuations for EuroQol health states. Med Care 35:1095–1108CrossRefPubMedGoogle Scholar
  33. 33.
    Lips P, Cooper C, Agnusdei D, Caulin F, Egger P, Johnell O et al. (1997) Quality of life as outcome in the treatment of osteoporosis: the development of a questionnaire for quality of life by the European Foundation for Osteoporosis. Osteoporos Int 7:36–38PubMedGoogle Scholar
  34. 34.
    Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148PubMedGoogle Scholar
  35. 35.
    Kellgren JH, Jeffrey MR, Ball J (1963) The epidemiology of chronic rheumatism: atlas of standard radiographs, 2nd edn. Blackwell, OxfordGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2004

Authors and Affiliations

  • N. M. van Schoor
    • 1
    Email author
  • J. H. Smit
    • 2
    • 3
  • J. W. R. Twisk
    • 1
    • 4
  • P. Lips
    • 1
    • 5
  1. 1.Institute for Research in Extramural MedicineVU University Medical CenterAmsterdamThe Netherlands
  2. 2.Department of Sociology and Social GerontologyVrije UniversiteitAmsterdamThe Netherlands
  3. 3.Department of PsychiatryVU University Medical CenterAmsterdamThe Netherlands
  4. 4.Department of Clinical Epidemiology and BiostatisticsVU University Medical CenterAmsterdamThe Netherlands
  5. 5.Department of EndocrinologyVU University Medical CenterAmsterdamThe Netherlands

Personalised recommendations