TY  - JOUR
PY  - 2013//
TI  - An increased rate of falling leads to a rise in fracture risk in postmenopausal women with self-reported osteoarthritis: a prospective multinational cohort study (GLOW)
JO  - Annals of the rheumatic diseases
A1  - Prieto-Alhambra, Daniel
A1  - Nogués, Xavier
A1  - Javaid, M. Kassim
A1  - Wyman, Allison
A1  - Arden, Nigel K.
A1  - Azagra, Rafael
A1  - Cooper, Cyrus
A1  - Adachi, Jonathan D.
A1  - Boonen, Steven
A1  - Chapurlat, Roland D.
A1  - Compston, Juliet E.
A1  - Gehlbach, Stephen H.
A1  - Greenspan, Susan L.
A1  - Hooven, Frederick H.
A1  - Netelenbos, J. Coen
A1  - Pfeilschifter, Johannes
A1  - Rossini, Maurizio
A1  - Sambrook, Philip N.
A1  - Silverman, Stuart
A1  - Siris, Ethel S.
A1  - Watts, Nelson B.
A1  - Díez-Pérez, Adolfo
SP  - 911
EP  - 917
VL  - 72
IS  - 6
N2  - OBJECTIVES: Patients with osteoarthritis have increased bone mass but no decrease in fractures. The association between self-reported osteoarthritis and incident falls and fractures was studied in postmenopausal women.METHODS: The Global Longitudinal Study of Osteoporosis in Women is a prospective multinational cohort of 60 393 non-institutionalised women aged ≥55 years who had visited primary care practices within the previous 2 years. Questionnaires were mailed at yearly intervals. Patients were classified as having osteoarthritis if they answered yes to the question, 'Has a doctor or other health provider ever said that you had osteoarthritis or degenerative joint disease?', and this was validated against primary care records in a subsample. Information on incident falls, fractures and covariates was self-reported. Cox and Poisson models were used for incident fractures and number of falls, respectively, to compute hazard ratios (HRs) and rate ratios (RRs) for baseline osteoarthritis status.RESULTS: Of 51 386 women followed for a median of 2.9 years (interquartile range 2.1-3.0), 20 409 (40%) reported osteoarthritis. The adjusted HR for osteoarthritis predicting fracture was 1.21 (95% CI 1.13 to 1.30; p<0.0001) and the adjusted RR for falls was 1.24 (95% CI 1.22 to 1.26; p<0.0001). However, the association between osteoarthritis and fracture was not significant after adjustment for incident falls (HR 1.06 (95% CI 0.98 to 1.15; p=0.13)).CONCLUSIONS: Postmenopausal women with self-reported osteoarthritis have a 20% increased risk of fracture and experience 25% more falls than those without osteoarthritis. These data suggest that increased falls are the causal pathway of the association between osteoarthritis and fractures.<p />  <p>Language: en</p>
LA  - en
SN  - 0003-4967
UR  - http://dx.doi.org/10.1136/annrheumdis-2012-201451
ID  - ref1
ER  -