The impact of osteoporosis on quality-of-life: The OFELY cohort.

Martin, A. R., Sornay-Rendu, E., Chandler, J. M., Duboeuf, F., Girman, C. J., & Delmas, P. D. (2002). Bone, 31(1), 32-36.

Severe osteoporosis manifests itself in different ways, including skeletal fractures, kyphosis, and pain. However, some individuals may show no outward signs of osteoporosis and may even be unaware of their condition due to the asymptomatic nature of low bone mineral density (BMD). Decreased health-related quality-of-life and functional status have been described primarily in terms of fracture-related pain and disability in women with severe osteoporosis, caused by vertebral fractures. The authors state that it is possible that health-related quality of life is also affected in women with osteoporosis who have never been diagnosed with fractures because their fear of future fractures induces them to make adaptations in their lifestyle to prevent falls and fractures. An osteoporosis-targeted quality-of-life survey instrument was developed to assess the effect of osteoporosis on women within a community. The questionnaire focused on three domains: physical difficulty, adaptations to one's daily life, and fears about the future.

The results of the study have implications for healthcare providers. Women with prior fractures, height loss, and/or kyphosis reported greater physical difficulties, more need to make adaptations to their lives, and greater fears than women reporting no such changes. The Physical Difficulty domain scores, however, did not differ significantly based on BMD alone. Thus, the negative effect of osteoporosis on quality of life was more related to the physical manifestations of osteoporosis than to bone density levels. The study is important in demonstrating the effect of osteoporosis-related factors on quality of life, although the major focus still continues to be education about osteoporosis, prevention, and early detection.