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Self-perceived facture risk: factors underlying women’s perception of risk for osteoporotic fractures: the Risk-Stratified Osteoporosis Strategy Evaluation study (ROSE)

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Abstract

Summary

This Danish cross-sectional study (n = 20,905) showed that women aged 65–81 years generally underestimated fracture risk compared to absolute risk estimated by the FRAX® algorithm. Significant association was found between risk factors (e.g., previous fracture, parental hip fracture, and self-rated heath) and self-perceived fracture risk. Although women recognized the importance of some fracture risk factors, a number of significant risk factors appeared to be less well known.

Introduction

The aim of this study is to investigate women’s self-perceived fracture risk and potential factors associated with this and to compare self-perceived risk with absolute fracture risk estimated by FRAX® in women aged 65–80 years.

Methods

Data from 20,905 questionnaires from the ROSE study were analyzed. The questionnaire included 25 items on osteoporosis, risk factors for fractures, and self-perceived risk of fractures and enabled calculation of absolute fracture risk by FRAX®. Data were analyzed using bivariate tests and regression models.

Results

Women generally underestimated their fracture risk compared to absolute risk estimated by FRAX®. Women with risk factors for facture estimated their fracture risk significantly higher than their peers. No correlation between self-perceived risk and absolute risk was found. The ordered logistic regression model showed a significant association between high self-perceived fracture risk and previous fragility fracture, parental hip fracture, falls, self-rated heath, conditions related to secondary osteoporosis, and inability to do housework.

Conclusions

These women aged 65–81 years underestimated their risk of fracture. However, they did seem to have an understanding of the importance of some risk factors such as previous fractures, parental hip fracture and falls. Risk communication is a key element in fracture prevention and should have greater focus on less well-known risk factors. Furthermore, it is important to acknowledge that risk perception is not based solely on potential risk factors but is also affected by experiences from everyday life to personal history.

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Acknowledgments

We thank the participants in the ROSE study and the editorial support of this article by Claire Gudex and the research group of ROSE (Katrine Hass Rubin, Teresa Friis-Holmberg, Mikkel Høibjerg, and Kim Brixen).

Funding

The ROSE study was supported by INTERREG 4A, the Region of Southern Denmark, and Odense University Hospital. The funding agencies had no direct role in the conduct of the study, data collection, analysis, and interpretation of the data or the preparation, review, and final approval of the manuscript.

Conflicts of interest

Mette Juel Rothmann, Jette Ammentorp, Mickael Bech, Jeppe Gram, Ole Winther Rasmussen, Reinhard Barkmann, Claus C Glüer, and Anne Pernille Hermann declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Endocrinology, Odense University Hospital, Kloevervaenget 10, 6.sal, 5000, Odense C, Denmark

    M. J. Rothmann & A. P. Hermann

  2. Health Services Research Unit, Lillebaelt Hospital/IRS, University of Southern Denmark, Vejle, Denmark

    M. J. Rothmann, J. Ammentorp & A. P. Hermann

  3. COHERE, Department of Business and Economics, University of Southern Denmark, Odense, Denmark

    M. Bech

  4. Department of Endocrinology, Hospital of Southwest Denmark, Esbjerg, Denmark

    J. Gram

  5. Department of Internal Medicine, Kolding Hospital, Kolding, Denmark

    O. W. Rasmussen

  6. Section Biomedical Imaging, Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Kiel, Germany

    R. Barkmann & C. C. Glüer

Authors
  1. M. J. Rothmann
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  2. J. Ammentorp
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  3. M. Bech
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  4. J. Gram
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  5. O. W. Rasmussen
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  6. R. Barkmann
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  7. C. C. Glüer
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  8. A. P. Hermann
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Corresponding author

Correspondence to M. J. Rothmann.

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Rothmann, M.J., Ammentorp, J., Bech, M. et al. Self-perceived facture risk: factors underlying women’s perception of risk for osteoporotic fractures: the Risk-Stratified Osteoporosis Strategy Evaluation study (ROSE). Osteoporos Int 26, 689–697 (2015). https://doi.org/10.1007/s00198-014-2936-6

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  • DOI: https://doi.org/10.1007/s00198-014-2936-6

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