Disease-specific perception of fracture risk and incident fracture rates: GLOW cohort study

作者：Gregson C L; Dennison E M; Compston J E; Adami S; Adachi J D; Anderson F A Jr; Boonen S; Chapurlat R; Diez Perez A; Greenspan S L; Hooven F H; LaCroix A Z; Nieves J W; Netelenbos J C; Pfeilschifter J; Rossini M; Roux C; Saag K G; Silverman S; Siris E S; Watts N B; Wyman A; Cooper C^*

来源：Osteoporosis International, 2014, 25(1): 85-95.

DOI：10.1007/s00198-013-2438-y

• Cerebrovascular event
• Fracture risk
• Multiple sclerosis
• Parkinson%26apos
• s disease
• Postmenopausal
• Self-perception

Accurate patient risk perception of adverse health events promotes greater autonomy over, and motivation towards, health-related lifestyles. %26lt;br%26gt;We compared self-perceived fracture risk and 3-year incident fracture rates in postmenopausal women with a range of morbidities in the Global Longitudinal study of Osteoporosis in Women (GLOW). %26lt;br%26gt;GLOW is an international cohort study involving 723 physician practices across ten countries (Europe, North America, Australasia); 60,393 women aged a parts per thousand yen55 years completed baseline questionnaires detailing medical history and self-perceived fracture risk. Annual follow-up determined self-reported incident fractures. %26lt;br%26gt;In total 2,945/43,832 (6.8 %) sustained an incident fracture over 3 years. All morbidities were associated with increased fracture rates, particularly Parkinson%26apos;s disease (hazard ratio [HR]; 95 % confidence interval [CI], 3.89; 2.78-5.44), multiple sclerosis (2.70; 1.90-3.83), cerebrovascular events (2.02; 1.67-2.46), and rheumatoid arthritis (2.15; 1.53-3.04) (all p %26lt; 0.001). Most individuals perceived their fracture risk as similar to (46 %) or lower than (36 %) women of the same age. While increased self-perceived fracture risk was strongly associated with incident fracture rates, only 29 % experiencing a fracture perceived their risk as increased. Under-appreciation of fracture risk occurred for all morbidities, including neurological disease, where women with low self-perceived fracture risk had a fracture HR 2.39 (CI 1.74-3.29) compared with women without morbidities. %26lt;br%26gt;Postmenopausal women with morbidities tend to under-appreciate their risk, including in the context of neurological diseases, where fracture rates were highest in this cohort. This has important implications for health education, particularly among women with Parkinson%26apos;s disease, multiple sclerosis, or cerebrovascular disease.

• 出版日期2014-1