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Khashayar P, Dimai HP, Moradi N, Fahimfar N, Gharibzadeh S, Ostovar A, Nabipour I, Larijani B. Protocol for a multicentre, prospective cohort study of clinical, proteomic and genomic patterns associated with osteoporosis to develop a multidimensional fracture assessment tool: the PoCOsteo Study. BMJ Open 2020; 10:e035363. [PMID: 32998914 PMCID: PMC7528352 DOI: 10.1136/bmjopen-2019-035363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The HORIZON 2020 project PoCOsteo aims (1) to develop a multidimensional fracture risk assessment tool which would take into account all factors known to be related to an individual's fracture risk. The fracture risk model is intended to be developed in two different populations, namely a European and a Middle Eastern one; (2) to develop a medical device, which would measure and/or quantify proteomic as well as genomic factors as present in whole blood samples collected through finger prick; (3) to test the clinical applicability and the validity of prototypes of the to be developed point of care device at both clinical centres. METHODS AND ANALYSIS This article presents the protocol of this prospective cohort that will be carried out independently at two different centres (Division of Endocrinology and Diabetology at the Medical University of Graz (MUG) as a clinic-based cohort, and Endocrinology and Metabolism Research Institute (EMRI) at the Tehran University of Medical Sciences (TUMS) as a population-based cohort). The final aim is to develop a fracture risk assessment model, which would include clinical risk factors, biochemical markers of bone turnover, as well as specific genomic factors. The derivation cohorts will consist of individuals aged 50 years and above. The period of observation for each patient will be 12 months; an extension phase, which would last for another 2 years, is also planned. ETHICS AND DISSEMINATION These studies are conducted in accordance with the World Medical Association Declaration of Helsinki. The Iranian part was approved by the Research Ethics Committee of EMRI, TUMS. The Austrian part was approved by the Ethics Committee of the Medical University of Graz. Based on the gathered information, a multidimensional fracture assessment tool will be designed which will later be added to the PoCOsteo device.
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Affiliation(s)
- Patricia Khashayar
- Center for Microsystems Technology, Imec & Ghent University, Zwijnaarde - Gent, Belgium
| | - Hans Peter Dimai
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Steiermark, Austria
| | - Nahid Moradi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran (the Islamic Republic of)
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran (the Islamic Republic of)
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
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Meriläinen M, Oikarinen P, Mikkonen K, Kaakinen P. Predictors of fragility fractures and osteoporosis among people over 50 years old - a retrospective cohort study. Int J Orthop Trauma Nurs 2019; 36:100709. [PMID: 31422067 DOI: 10.1016/j.ijotn.2019.100709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 07/07/2019] [Accepted: 07/31/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Merja Meriläinen
- Oulu University Hospital, The Operational Division, Box 21, 90029, OYS, Oulu, Finland.
| | - Pirjo Oikarinen
- Oulu University Hospital, The Operational Division, Department of Orthopedic Surgery, Oulu, Finland
| | - Kristina Mikkonen
- Research Unit of Nursing Science and Health Management, Medical Research Group, Box 5000, 90014, University of Oulu, Oulu, Finland.
| | - Pirjo Kaakinen
- Research Unit of Nursing Science and Health Management, Medical Research Group, Box 5000, 90014, University of Oulu, Oulu, Finland.
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Silva DMW, Lazaretti-Castro M, Freitas Zerbini CAD, Szejnfeld VL, Eis SR, Borba VZC. Incidence and excess mortality of hip fractures in a predominantly Caucasian population in the South of Brazil. Arch Osteoporos 2019; 14:47. [PMID: 30993406 DOI: 10.1007/s11657-019-0597-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 04/01/2019] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Osteoporosis is a very common disease, and data on its epidemiology is important for health care strategy implementation. Brazil is a developing country; its population is aging, leading to an expected increase in hip fractures and their undesirable consequences. OBJECTIVE Assess the incidence of osteoporotic hip fractures and subsequent mortality in Southern Brazil as part of a large epidemiological study aiming to reinforce the data for FRAX Brazil. STUDY DESIGN This study evaluated all admissions for fragility hip fractures between April 1, 2010, and March 31, 2012, in the city of Joinville, including both genders of patients 50 years old or older, which corresponded to 19.2% of the local population. Joinville was chosen because it is the third largest city in the south of Brazil, with a representative population predominantly composed of descendants of European immigrants. RESULTS There were 213 cases of hip fractures, predominantly in Caucasians (n = 204, 96.7%) whose mean age was 77.7, ± 10.5, of which 143 (67.1%) were women (79.5 ± 9.6 years) and 70 (32.9%) were men (74 ± 11.3 years). The annual incidence of hip fractures was 268.8 for women and 153.0 for men/100,000 inhabitants. In the 60 to 64-year group, the overall incidence was 92.1/100,000, with an age-related increase of 1410.1/100,000 in the 80 to 84-year group. The mortality rate during hospitalization was 7.5%, and 25% died during the 12 months following their fractures. CONCLUSION The incidence of hip fractures among the oldest in this predominantly Caucasian population living in Southern Brazil was similar to that of European populations from the northern hemisphere. The annual incidence of fragility hip fractures among people in their 80s was 59 times higher than that among people in their 50s. The mortality rate was 4.3 times higher in the first year after hip fracture than in the age-related local population.
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Affiliation(s)
- Dalisbor Marcelo Weber Silva
- Medical School of Univille, Universidade da Região de Joinville, 520, Anita Garibaldi, Joinville, SC, 89212-050, Brazil.
| | - Marise Lazaretti-Castro
- Osteometabolic Diseases Service of the Department of Endocrinology, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Vera Lúcia Szejnfeld
- Department of Rheumatology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sergio Ragi Eis
- Diagnosis and Research Center in Osteoporosis of Espirito Santo, Vitoria, Brazil
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Prognostic Relevance of Circulating 25OHD Fractions for Early Recovery and Survival in Patients with Hip Fracture †. J Clin Med 2018; 7:jcm7080193. [PMID: 30071650 PMCID: PMC6111530 DOI: 10.3390/jcm7080193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 07/28/2018] [Accepted: 07/28/2018] [Indexed: 12/14/2022] Open
Abstract
The relation between vitamin-D (VD) status and healing after hip fracture had not been sufficiently addressed. Currently serum total 25-hydroxy-VD (t-25OHD) is the most widely used indicator of VD status. It is unclear whether free or bioavailable VD are better markers of 25OHD availability for tissues. Validity of overall cut-off values of t-25OHD is limited. OBJECTIVES (1) Assess serum levels of circulating forms of 25OHD in patients with hip fracture (PwHF: N = 199) compared to active controls without history of fracture (N = 102); (2) determine relationship between 25OHD fractions and functional performance after surgery (FPAS) and survival. The t-25OHD; VD binding protein and albumin levels were measured. Comorbidities; lifestyle; FPAS and survival were recorded at seven months. VD deficiency occurred more frequently in PwHF than in controls (72% vs. 38%). Patients with better FPAS showed higher 25OHD in all fractions than with poor FPAS. Controlled by lifestyle; 25OHD levels were independent predictive factors (p < 0.001). Good FPAS values forecasted longer survival (OR: 6.5CI:3.2⁻13.3; p < 0.0001). All 25OHD forms showed a tendency to predict survival. Mortality rate decreased to 8% in individuals with t-25OHD levels of >22.6⁻39.5 nmol/L and increased to 14% with >40 nmol/L. These observations highlight the importance of serum 25OHD assessment and moderate VD substitution for healing and survival.
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Hip fracture incidence 2003-2013 and projected cases until 2050 in Austria: a population-based study. Int J Public Health 2016; 61:1021-1030. [PMID: 27549873 DOI: 10.1007/s00038-016-0878-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 03/11/2016] [Accepted: 08/16/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES Elevated hip fracture incidence is a major public health problem looming to aggravate in industrialized countries due to demographic developments. We report hip fracture incidence and expected future cases from Vorarlberg, the westernmost province of Austria, results potentially representative of Central European populations. METHODS Crude and standardized hip fracture incidence rates in Vorarlberg 2003-2013 are reported. Based on the age-specific incidence in 2013 or trends 2003-2013, we predict hip fractures till 2050. RESULTS Female age-standardized hip fracture incidence decreased 2005-2013, whereas for men, the trend was rather unclear. Uncorrected forecasts indicate that by 2050, female and male cases will each have more than doubled from 2015 in all demographic core scenarios. Corrected by incidence trends before 2013, cases are expected to drop among women but rise among men. CONCLUSIONS We anticipate rising hip fracture numbers in Vorarlberg within the next decades, unless prevention programs that presumably account for decreasing incidence rates, particularly among women since 2005, take further effect to counteract the predicted steady increase due to demographic changes. Concomitantly, augmented endeavors to target the male population by these programs are needed.
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Stamm TA, Pieber K, Crevenna R, Dorner TE. Impairment in the activities of daily living in older adults with and without osteoporosis, osteoarthritis and chronic back pain: a secondary analysis of population-based health survey data. BMC Musculoskelet Disord 2016; 17:139. [PMID: 27020532 PMCID: PMC4810518 DOI: 10.1186/s12891-016-0994-y] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 03/22/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Independence in performing activities of daily living (ADLs) is a central aspect of functioning. Older adults frequently experience impairments and limitations in functioning in various life areas. The aim of this survey was to explore the limitations in the ADLs in older adults in a population-based survey in Austria. METHOD A population-based cross-sectional study in 3097 subjects aged ≥65 years who were included in the Austrian health interview survey was performed. Descriptive statistics were used to calculate frequencies of problems in the ADLs. A principal component analysis was applied to analyze the main dimensions of 19 ADL items. Binary logistic regression models were used with the ADL dimensions as the dependent variables and osteoarthritis, chronic back pain, osteoporosis, sex, education level, anxiety or depression, age and pain intensity as independent variables. RESULTS People with musculoskeletal conditions were significantly more often affected by ADL problems than people without these diseases. The ADL domain which caused problems in the highest proportion of people was "doing heavy housework" (43.9 %). It was followed by the ADL domains "bending or kneeling down" (39.3 %), "climbing stairs up and down without walking aids" (23.1 %), and "walking 500 m without walking aids" (22.8 %). The principal components analysis revealed four dimensions of ADLs: (1) intense "heavy burden" ADLs, (2) basic instrumental ADLs, (3) basic ADLs and (3) hand-focused ADLs. The proportion of subjects who had problems with the respective dimensions was 58.2, 29.2, 23.0, and 9.2 %. Anxiety/depression (greatest effect), followed by the chronic musculoskeletal disease itself, female sex, higher age and pain intensity were significant predictors of ADL problems. CONCLUSION This population-based survey indicates that older people have considerable ADL problems. More attention should be paid to the high impact of pain intensity, anxiety and depression on ADLs.
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Affiliation(s)
- Tanja Alexandra Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna and Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
| | - Karin Pieber
- Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Vienna, Austria
| | - Thomas Ernst Dorner
- Institute of Social Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
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Kim KJ, Jun HJ, Jeong HS, Jeon DJ, Ji SH. The relationship between fracture and quality of life in Korean adults receiving treatment for osteoporosis based on the 2010 Korean Community Health Survey. J Phys Ther Sci 2015; 27:2083-6. [PMID: 26311930 PMCID: PMC4540822 DOI: 10.1589/jpts.27.2083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 03/24/2015] [Indexed: 01/24/2023] Open
Abstract
[Purpose] The purpose of this study was to investigate the relationship between fracture
and quality of life in Korean adults receiving treatment for osteoporosis based on the
2010 Korean Community Health Survey (KCHS). [Subjects and Methods] This study utilized the
raw data of the 2010 KCHS. In the survey, osteoporosis was assessed in 228,903 subjects,
excluding 326 for whom there was insufficient data. There were 17,387 subjects with
osteoporosis confirmed by a doctor’s diagnosis and 9,419 of them were being treated for
osteoporosis at the time of the survey. [Results] Among the patients being treated, those
with fractures had a significantly lower QOL than patients who did not experience
fractures. The lower QOL scores were caused by hip, vertebral and wrist fractures, and in
all cases, QOL was significantly lower. Greater numbers of fractures significantly lowered
QOL scores compared to participants without fractures. [Conclusion] Fractures in patients
receiving treatment for osteoporosis have a direct impact on QOL. Among the different
types of fractures, hip fractures resulted in the lowest scores. Therefore, to avoid
additional fractures caused by inappropriate management of osteoporosis, we suggest that
there is a need to improve fall related self-efficacy and prevention programs.
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Affiliation(s)
- Ki-Jong Kim
- Department of Physical Therapy, Cheongam College, Republic of Korea
| | - Hyun-Ju Jun
- Department of Physical Therapy, Cheongam College, Republic of Korea
| | - Han-Shin Jeong
- Department of Physical Therapy, Kunjang College, Republic of Korea
| | - Dae-Jung Jeon
- Department of Physical Therapy, KS Hospital, Republic of Korea
| | - Sung-Ha Ji
- Department of Physical Therapy, Jungangseng Korean Hospital, Republic of Korea
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Winklmayr M, Kluge C, Winklmayr W, Küchenhoff H, Steiner M, Ritter M, Hartl A. Radon balneotherapy and physical activity for osteoporosis prevention: a randomized, placebo-controlled intervention study. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2015; 54:123-136. [PMID: 25274266 DOI: 10.1007/s00411-014-0568-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 09/11/2014] [Indexed: 06/03/2023]
Abstract
Low-dose radon hyperthermia balneo treatment (LDRnHBT) is applied as a traditional measure in the non-pharmacological treatment of rheumatic diseases in Europe. During the last decades, the main approach of LDRnHBT was focused on the treatment of musculoskeletal disorders, but scientific evidence for the biological background of LDRnHBT is weak. Recently, evidence emerged that LDRnHBT influences bone metabolism. We investigated, whether combined LDRnHBT and exercise treatment has an impact on bone metabolism and quality of life in a study population in an age group at risk for developing osteoporosis. This randomized, double-blind, placebo-controlled trial comprised guided hiking tours and hyperthermia treatment in either radon thermal water (LDRnHBT) or radon-free thermal water (PlaceboHBT). Markers of bone metabolism, quality of life and somatic complaints were evaluated. Statistics was performed by linear regression and a linear mixed model analysis. Significant changes over time were observed for most analytes investigated as well as an improvement in self-assessed health in both groups. No significant impact from the LDRnHBT could be observed. After 6 months, the LDRnHBT group showed a slightly stronger reduction of the osteoclast stimulating protein receptor activator of nuclear kB-ligand compared to the PlaceboHBT group, indicating a possible trend. A combined hyperthermia balneo and exercise treatment has significant immediate and long-term effects on regulators of bone metabolism as well as somatic complaints. LDRnHBT and placeboHBT yielded statistically equal outcomes.
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Affiliation(s)
- Martina Winklmayr
- Institute of Physiology and Pathophysiology, Paracelsus Medical University Salzburg, Strubergasse 21, 5020, Salzburg, Austria
| | - Christian Kluge
- Statistical Consulting Unit, Department of Statistics, Ludwig Maximilians Universität München, Akademiestr.1, 80799, München, Germany
| | | | - Helmut Küchenhoff
- Statistical Consulting Unit, Department of Statistics, Ludwig Maximilians Universität München, Akademiestr.1, 80799, München, Germany
| | - Martina Steiner
- Institute of Physiology and Pathophysiology, Paracelsus Medical University Salzburg, Strubergasse 21, 5020, Salzburg, Austria
| | - Markus Ritter
- Gastein Research Institute, Paracelsus Medical University, Schareckstrasse 4, 5640, Bad Gastein, Austria
| | - Arnulf Hartl
- Institute of Physiology and Pathophysiology, Paracelsus Medical University Salzburg, Strubergasse 21, 5020, Salzburg, Austria.
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Brozek W, Reichardt B, Kimberger O, Zwerina J, Dimai HP, Kritsch D, Klaushofer K, Zwettler E. Mortality after hip fracture in Austria 2008-2011. Calcif Tissue Int 2014; 95:257-66. [PMID: 24989776 DOI: 10.1007/s00223-014-9889-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 06/10/2014] [Indexed: 02/07/2023]
Abstract
Osteoporosis-related hip fractures represent a substantial cause of mortality and morbidity in industrialized countries like Austria. Identification of groups at high risk for mortality after hip fracture is crucial for health policy decisions. To determine in-hospital, long-term, and excess mortality after osteoporosis-related hip fracture in Austrian patients, we conducted a retrospective cohort analysis of pseudonymized invoice data from Austrian social insurance authorities covering roughly 98 % of the entire population. The data set included 31,668 subjects aged 50 years and above sustaining a hip fracture between July 2008 and December 2010 with follow-up until June 2011, and an age-, gender-, and regionally matched control population without hip fractures (56,320 subjects). Kaplan-Meier and Cox hazard regression analyses served to determine unadjusted and adjusted mortality rates: Unadjusted all-cause 1-year mortality amounted to 20.2 % (95 % CI: 19.7-20.7 %). Males had significantly higher long-term, in-hospital, and excess mortality rates than females, but younger males exhibited lower excess mortality than their female counterparts. Advanced age correlated with increased long-term and in-hospital mortality, but lower excess mortality. Excess mortality, particularly in males, was highest in the first 6 months after hip fracture, but remained statistically significantly elevated throughout the observation period of 3 years. Longer hospital stay per fracture was correlated with mortality reduction in older patients and in patients with more subsequent fractures. In conclusion, more efforts are needed to identify causes and effectively prevent excess mortality especially in male osteoporosis patients.
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Affiliation(s)
- Wolfgang Brozek
- Ludwig Boltzmann Institute of Osteology, Hanusch Hospital of the WGKK and AUVA Trauma Center, 1st Medical Department at Hanusch Hospital, Heinrich Collin Str. 30, 1140, Vienna, Austria,
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Stamm TA, Pieber K, Blasche G, Dorner TE. Health care utilisation in subjects with osteoarthritis, chronic back pain and osteoporosis aged 65 years and more: mediating effects of limitations in activities of daily living, pain intensity and mental diseases. Wien Med Wochenschr 2014; 164:160-6. [PMID: 24468829 DOI: 10.1007/s10354-014-0262-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 01/07/2014] [Indexed: 11/29/2022]
Abstract
Musculoskeletal diseases (MDs) have major consequences for the individual, and also for society and may thus lead to increased use of health care. It was the aim of this study to explore health care utilisation in patients with self-reported osteoarthritis, chronic back pain or osteoporosis compared with people of the same age without those diseases, based on data of the Austrian health interview survey including 3,097 subjects aged ≥ 65 years. Patients with MDs in our study visited a general practitioner (GP) and were hospitalised significantly more often compared with persons without the respective diseases. Problems in the activities of daily living (ADLs), pain intensity and anxiety/depression influenced GP consultations. Complex factors explain the higher health care utilisation in subjects with MDs in our study. Our results indicate that integrated strategies are needed to manage those patients, which should focus on management of ADL problems, pain and mental health.
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Affiliation(s)
- Tanja Alexandra Stamm
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria,
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Dorner TE, Stein KV. Prevalence and status quo of osteoarthritis in Austria. Analysis of epidemiological and social determinants of health in a representative cross-sectional survey. Wien Med Wochenschr 2013; 163:206-11. [PMID: 23377950 DOI: 10.1007/s10354-013-0174-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 01/02/2013] [Indexed: 10/27/2022]
Abstract
Osteoarthritis has a major impact on mobility and functioning leading to impairment in activities of daily living and quality of life. The aim of our analysis was to reveal the prevalence of self-reported, doctor-diagnosed osteoarthritis with a representative population based survey, including data for 15,474 subjects. Prevalence of osteoarthritis was 11.9 % in men and 18.6 % in women. A total of 73.4 % of men and 74.9 % of women with osteoarthritis reported to have had severe pain in the last 12 months; 60.3 % of male and 67.0 % of female patients reported that the disease was treated within the last 12 months. Age, socio-economic parameters, overweight and obesity, as well as living in a rural area were significant predictors of osteoarthritis. Even if the onset of osteoarthritis may not be averted, public health and prevention programmes may improve quality of life significantly if they are adequately tuned to sex, age and personal capabilities.
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Affiliation(s)
- Thomas Ernst Dorner
- Institute of Social Medicine, Centre for Public Health, Medical University Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
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Pluskiewicz W, Adamczyk P, Czekajło A, Grzeszczak W, Burak W, Drozdzowska B. Epidemiological data on osteoporosis in women from the RAC-OST-POL study. J Clin Densitom 2012; 15:308-14. [PMID: 22425509 DOI: 10.1016/j.jocd.2012.01.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Revised: 01/02/2012] [Accepted: 01/10/2012] [Indexed: 10/28/2022]
Abstract
In the RAC-OST-POL study, epidemiological data were presented concerning osteoporosis in 625 women older than 55 yr coming from the District of Raciborz in Poland. The mean age was 66.4 ± 7.8 yr. All the women fulfilled a questionnaire, gathering data on clinical risk factors of osteoporosis. Femoral neck (FN) and total hip (TH) were measured. The mean value of bone mineral density for FN was 0.862 ± 0.129 g/cm(2), T-score -1.25 ± 0.92, and Z-score 0.039 ± 0.78, whereas the respective values for TH were 0.945 ± 0.149 g/cm(2), -0.47 ± 1.19, and 0.52 ± 0.98. T-score for FN below -2.5 was noted in 59 women (9.5%) and for TH in 23 women (3.7%). One hundred seventy six women reported prior osteoporotic fracture(s) (28.2%). Falls were the most common clinical risk factor. The number of clinical risk factors was significantly higher in subjects with fracture history than in those without fracture records. The only first-line antiresorptive medications, used in the therapy for osteoporosis, included alendronate-42 subjects (6.7%). Estrogen therapy was prescribed in 135 women and 7 were treated with calcitonin. Calcium was administered in 94 patients and vitamin D in 84 women. In all the women on therapy, Z-score values were significantly lower than in untreated women. Concluding, the results of our epidemiological study demonstrate low treatment rate in women with history of low trauma fracture. Effective strategies are needed for prevention, especially in regard to falls, and management of this disease, in particular for improvement of the treatment rates in affected women with prior fracture, in general.
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Affiliation(s)
- Wojciech Pluskiewicz
- Metabolic Bone Diseases Unit, Department and Clinic of Internal Diseases, Diabetology and Nephrology, Medical University of Silesia, Katowice, Poland.
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Gosch M, Pils K. [Geriatric traumatology--new treatments, new opportunities]. Z Gerontol Geriatr 2011; 44:361-2. [PMID: 22159828 DOI: 10.1007/s00391-011-0257-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Bortolon PC, Andrade CLTD, Andrade CAFD. [Characteristics of hospital admissions in the Unified National Health System for osteoporotic hip fracture in elderly people in Brazil, 2006-2008]. CAD SAUDE PUBLICA 2011; 27:733-42. [PMID: 21603756 DOI: 10.1590/s0102-311x2011000400012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 02/14/2011] [Indexed: 11/22/2022] Open
Abstract
Osteoporosis is a multifactorial syndrome of the skeletal system, and hip fracture is the most serious consequence for the elderly, due to the high mortality and cost. This article describes osteoporotic hip fractures in Brazilian elderly in 2006-2008. Secondary data were obtained from the Authorization Forms for Hospital Admissions (AIH) and allowed the creation of indicators for hip fracture in elders. The proportion of elderly patients hospitalized for hip fractures in the Unified National Health System was 1%. The percentages of hospital admissions and deaths were higher in females, and increased with age. Hip fractures accounted for approximately 2% of health care expenditures for persons 60 years or older. Length of hospital stay ranged from one to seven days, 50.1% occurred in charity hospitals, and 42.7% occurred outside the county of residence. The findings emphasize the need for greater attention to osteoporosis and show the relevance of costs in hospital admissions for elderly with osteoporotic hip fractures. Understanding such hospitalizations can contribute to the formulation of health policies to address this issue.
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Affiliation(s)
- Paula Chagas Bortolon
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rua Senador Vergueiro 200, Rio de Janeiro, RJ, Brazil.
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Pietschmann P, Azizi-Semrad U, Pils K, Fahrleitner-Pammer A, Resch H, Dobnig H. Pharmacologic undertreatment of osteoporosis in Austrian nursing homes and senior's residences. Wien Klin Wochenschr 2010; 122:532-7. [PMID: 20730567 DOI: 10.1007/s00508-010-1428-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Accepted: 08/02/2010] [Indexed: 10/19/2022]
Abstract
Osteoporosis is a classical age-related disease. Although significant progress in treatment has been achieved and antifracture efficacy proven over the past years undertreatment is still a general problem. There are only few published data available regarding osteoporosis and its treatment encountered in Austrian nursing homes and seniors' residences where fractures are especially frequent. We therefore conducted a survey in 89 participating institutions in order to assess frequency of documented osteoporosis as well as prevalence status of anti-osteoporotic drug usage in this special population. Data were acquired using a questionnaire and analyzed in a descriptive manner. Mean age of the residents was 82 years and the majority was female (76%). Half of the subjects took 5-8 different drugs per day and 23% received more than 8. Almost one-fourth (21.2%) of the residents had a diagnosis of osteoporosis. A history of hip fracture or other fractures was documented in 10.4% and 13.2%, respectively. Only 8.2% of the residents were treated with calcium, 6.2% with vitamin D and 9.3% received a combination of vitamin D and calcium. Specific osteoporosis treatment was prescribed to 7.2% only. In conclusion, this study reflects a high degree of continuing unawareness toward a diagnosis of osteoporosis in Austrian nursing homes and seniors' residences. The data of this survey further indicate that undertreatment is still very common in this population at very high risk of fractures.
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Affiliation(s)
- Peter Pietschmann
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
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Editorial: Osteoporose: Eine Herausforderung für die Prävention. Wien Med Wochenschr 2009; 159:219-20. [DOI: 10.1007/s10354-009-0675-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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