Figure 1
Selection of the study population.
Table 1
Characteristics of the study groups at baseline and endpoint.
| OSTPRE POPULATION RESPONDERS IN 1994 (N = 11149) | CONTROL GROUP (NO FRAGILITY FRACTURES DURING FU) (N = 4674) | FRACTURE GROUP (ONE OR MORE FRAGILITY FRACTURES DURING FU) (N = 1938) | Pa | |
|---|---|---|---|---|
| Mean age at baseline (SD) | 57.3 (2.9) | 56.8 (2.8) | 57.2 (2.9) | <0.001 |
| Mean baseline BMI (kg/m2) (SD) | 27.1 (4.5) | 26.7 (4.0) | 26.7 (4.1) | 0.892 |
| Mean number of chronic diseases at baseline (SD) | 1.5 (1.4) | 1.7 (1.2) | 1.8 (1.2) | 0.001 |
| PREVALENCE OF SELF-REPORTED DISEASES AT BASELINE (1994), % (N) | Pb | |||
| Osteoporosis/osteopenia | 0.7 (73) | 0.4 (17) | 1.0 (20) | 0.001 |
| Rheumatoid arthritis | 3.6 (406) | 2.7 (124) | 2.7 (52) | 0.945 |
| Chronic back pain | 22.4 (2496) | 20.2 (546) | 21.0 (407) | 0.473 |
| Chronic mental health disorder (not specified) | 6.8 (754) | 4.8 (225) | 4.6 (89) | 0.700 |
| Ischaemic heart disease | 8.7 (975) | 6.1 (286) | 8.0 (156) | 0.008 |
| Hypertension | 25.4 (2830) | 21.5 (1003) | 21.0 (407) | 0.679 |
| Other heart disease | 7.3 (814) | 5.3 (249) | 6.5 (126) | 0.060 |
| Asthma | 6.8 (756) | 5.7 (265) | 6.9 (134) | 0.053 |
| Diabetes | 2.7 (303) | 1.0 (46) | 1.1 (21) | 0.713 |
| Stroke | 2.0 (221) | 1.3 (62) | 1.7 (33) | 0.242 |
| Cancer | 4.7 (526) | 3.3 (156) | 3.5 (68) | 0.726 |
| PREVALENCE OF SELF-REPORTED DISEASES AT THE ENDPOINT (2014), % (N) | OSTPRE POPULATION RESPONDERS IN 2014 (N = 7536) | CONTROL GROUP (NO FRAGILITY FRACTURES DURING FU) (N = 4674) | FRACTURE GROUP (ONE OR MORE FRAGILITY FRACTURES DURING FU) (N = 1938) | Pb |
| Osteoporosis/osteopenia | 9.8 (737) | 7.1 (331) | 17.9 (347) | <0.001 |
| Rheumatoid arthritis | 4.5 (339) | 4.3 (199) | 5.9 (114) | 0.005 |
| Chronic back pain | 14.9 (1123) | 15.4 (718) | 16.9 (328) | 0.113 |
| Chronic mental health disorder (not specified) | 2.4 (179) | 2.4 (111) | 2.8 (55) | 0.273 |
| Ischaemic heart disease | 17.0 (1283) | 17.2 (804) | 19.1 (370) | 0.067 |
| Hypertension | 56.7 (4272) | 59.9 (2799) | 60.5 (1173) | 0.628 |
| Other heart disease | 15.2 (1149) | 15.3 (713) | 18.0 (349) | 0.006 |
| Asthma | 14.2 (1071) | 14.0 (655) | 17.1 (331) | 0.001 |
| Diabetes | 17.1 (1287) | 18.1 (848) | 17.0 (329) | 0.259 |
| Stroke | 2.4 (180) | 2.4 (110) | 2.9 (57) | 0.166 |
| Cancer | 10.4 (779) | 10.9 (510) | 10.6 (206) | 0.737 |
[i] a) One-way ANOVA, b) a Chi-square analysis between the fracture and control groups.
Figure 2
Good physical capability (PC) of women with one, two or three or more fragility fractures during the follow-up.
Figure 3
Good self-rated health (SRH) of women with one, two or three or more fragility fractures during the follow-up.
Table 2
Longitudinal ordinal regression analysis (GEE with logit link) for PC and SRH. The first model includes only the cumulative fractures (and time point) as a predictor, the second adds BMI and age, the third model adds level of education (basic, intermediate/upper secondary education, advanced/tertiary education) and Charlson comorbidity index (CCI) scores (none—score 0, mild—score 1–2, moderate—score 3–4, severe—score 5+). Estimates are reported as odds ratios with 95% confidence intervals.
| MODEL 1 | MODEL 2 | MODEL 3 | |||||||
|---|---|---|---|---|---|---|---|---|---|
| ODDS RATIO | 95% CI | p-VALUE | ODDS RATIO | 95% CI | p-VALUE | ODDS RATIO | 95% CI | p-VALUE | |
| Physical capability | |||||||||
| No fractures | 1 | ref. | 1 | ref. | 1 | ref. | |||
| 1 fracture | 1.21 | 1.07–1.37 | 0.0021 | 1.21 | 1.06–1.37 | 0.0043 | 1.16 | 1.01–1.32 | 0.0292 |
| 2 fractures | 1.59 | 1.30–1.94 | <0.0001 | 1.58 | 1.28–1.95 | <0.0001 | 1.53 | 1.23–1.90 | <0.0001 |
| 3 or more fractures | 2.08 | 1.58–2.74 | <0.0001 | 2.11 | 1.58–2.81 | <0.0001 | 1.93 | 1.43–2.61 | <0.0001 |
| BMI | 1.14 | 1.13–1.16 | <0.0001 | 1.13 | 1.12–1.14 | <0.0001 | |||
| Age | 1.15 | 1.13–1.17 | <0.0001 | 1.13 | 1.11–1.15 | <0.0001 | |||
| Education basic | 1 | ref. | |||||||
| Education intermediate | 0.83 | 0.74–0.93 | 0.0019 | ||||||
| Education high | 0.58 | 0.45–0.74 | <0.0001 | ||||||
| CCI none | 1 | ref. | |||||||
| CCI mild | 1.79 | 1.60–2.00 | <0.0001 | ||||||
| CCI moderate | 3.22 | 2.73–3.80 | <0.0001 | ||||||
| CCI severe | 5.78 | 4.39–7.60 | <0.0001 | ||||||
| Self-rated health | |||||||||
| No fractures | 1 | ref. | 1 | ref. | 1 | ref. | |||
| 1 fracture | 1.10 | 0.99–1.22 | 0.0805 | 1.09 | 0.98–1.22 | 0.1055 | 1.07 | 0.96–1.20 | 0.2059 |
| 2 fractures | 1.47 | 1.21–1.79 | 0.0001 | 1.47 | 1.21–1.78 | 0.0001 | 1.40 | 1.16–1.70 | 0.0006 |
| 3 or more fractures | 1.31 | 0.98–1.74 | 0.0680 | 1.39 | 1.04–1.87 | 0.0270 | 1.27 | 0.93–1.73 | 0.1318 |
| BMI | 1.10 | 1.09–1.11 | <0.0001 | 1.08 | 1.07–1.09 | <0.0001 | |||
| Age | 1.04 | 1.02–1.05 | <0.0001 | 1.02 | 1.00–1.04 | 0.0302 | |||
| Education basic | 1 | ref. | |||||||
| Education intermediate | 0.64 | 0.58–0.71 | <0.0001 | ||||||
| Education high | 0.41 | 0.34–0.50 | <0.0001 | ||||||
| CCI none | 1 | ref. | |||||||
| CCI mild | 1.89 | 1.75–2.05 | <0.0001 | ||||||
| CCI moderate | 2.34 | 2.02–2.71 | <0.0001 | ||||||
| CCI severe | 3.42 | 2.60–4.49 | <0.0001 | ||||||