Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures

Fractures and subsequent morbidity determine the impact of established post menopausal osteoporosis. Health-related quality of life (HRQOL) has become an important outcome criterion in the assessment and follow-up of osteoporo tic patients. As part of the baseline measurements of the Multiple Outcomes of Raloxifene Evaluation (MORE) study, HRQOL was assessed in 751 osteoporo tic (bone mineral density [BMD] T score greater than or equal to -2.5) wome n from Europe with or without vertebral fractures (VFX), This was done usin g the quality of life questionnaire of the European Foundation for Osteopor osis (QUALEFFO), Nottingham Health Profile (NHP) and the EQ-5D (former Euro Qol), QUALEFFO contains questions in five domains: pain, physical function, social function, general health perception, and mental function. Each doma in score and QUALEFFO total scores are expressed on a 100-point scale, with 0 corresponding to the best HRQOL. In comparison with patients without VFX , those with VFX were older (66.2 +/- 5.9 years vs. 68.8 +/- 6.3 years; p < 0.001), had higher prevalence of nonvertebral fractures (25% vs. 36%; p = 0.002), and higher QUALEFFO scores (worse HRQOL; total score, 26 +/- 14 vs. 36 +/- 17; p < 0.001). QUALEFFO scores increased progressively with increa sing number of VFX, especially lumbar fractures (p < 0.001). Patients with a single VFX already had a significant increase in QUALEFFO scores (p < 0.0 5), Similar, though weaker, associations were seen for NHP and EQ-5D scores . This study confirms decreased HRQOL for patients with prevalent VFX, In o steoporotic patients, QUALEFFO scores change in relation to the number of V FX, QUALEFFO is suitable for clinical studies in patients with postmenopaus al osteoporosis.