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"Many women aren't making the connection between their osteoporosisdiagnosis and the serious consequences of the disease, namely the risk offractures and the disability associated with those fractures," said EthelSiris, M.D., GLOW investigator and Director of the Toni Stabile OsteoporosisCenter of the Columbia University Medical Center, New York-PresbyterianHospital, New York, New York. "This study underscores the need for physiciansto help patients better understand the meaning of an osteoporosis diagnosis,not just from a clinical perspective but also from the perspective of how itcould potentially impact their lives."
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By definition, osteoporosis causes bones to become fragile and thereforemore likely to break. If left untreated, the disease can progress painlesslyuntil a fracture occurs. One in two women over 50 will suffer an osteoporosisrelated fracture in their remaining lifetime,(1) potentially causing chronicpain, reduced mobility, loss of independence and increased risk of death.(2,3)
Results from a second GLOW study also presented at ASBMR indicated thatexperiencing even one fracture after the age of 45 years can reduce a woman'squality of life. This was observed for each of ten different fracture sitesevaluated, namely the spine, ankle, arm, collarbone, hip, pelvis, rib, wrist,and upper and lower leg.
"Currently osteoporosis remains under-diagnosed and undertreated," saidCyrus Cooper, M.D., GLOW investigator and Director of the MRC EpidemiologyResource Centre, University of Southampton, and Norman Collison Chair ofMusculoskeletal Sciences, University of Oxford, United Kingdom. "We hope thatGLOW will highlight the deep impact that a fracture can have on a patient'slife and create an awareness among health professionals that preventivetherapy should be commenced urgently in patients with osteoporotic fractures."
Study Details
GLOW is a prospective, longitudinal, observational study of women 55 yearsof age and older who visited a primary care physician during the two yearsprior to the study. Over 60,000 women have been recruited through over 700primary care physicians in 17 cities in the United States, Canada, Europe, andAustralia. GLOW is gathering information on osteoporosis risk factors,treatment approaches, patient behaviour, and fracture outcomes with an annualpatient survey over a 5 year period.
Self-perceived risk of fracture was assessed using a five-point scaleranging from "much lower" to "much higher" risk than other women of the sameage. Of 60,112 patients, 11,276 reported an osteoporosis diagnosis.
Data on the occurrence of fracture since the age of 45 years was collectedfor 10 skeletal sites (spine, ankle, arm, collarbone, hip, pelvis, rib, wrist,and upper and lower leg). Fracture history was correlated to a patient'shealth-related quality of life as measured by EuroQoL EQ-5D,(4) an instrumentthat assesses health in the areas of mobility, self-care, usual activities ofdaily living, pain, and depression. The score is expressed as a healthutility score, 1 representing perfect health and 0 representing death.Patients completing all of the EQ-5D questions (56,866) were included in theanalysis. Mean EQ-5D scores were significantly higher in women with nofractures versus those with one or multiple fractures since the age of 45years (0.78 vs. 0.74 and 0.65, respectively). The mean health utility scoreranged from 0.76 for women with wrist fractures to 0.64 for women with spinalfractures.
