Investigating the relationship between self-perception of fracture risk and prior fracture: findings from the Hertfordshire Cohort Study.
Investigating the relationship between self-perception of fracture risk and prior fracture: findings from the Hertfordshire Cohort Study.
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DOI：
10.1007/s40520-022-02322-6
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发表时间：
2023-03
影响因子：
4
通讯作者：
Dennison, Elaine M. M.
中科院分区：
文献类型：
--
作者：
Bevilacqua, Gregorio;Westbury, Leo D. D.;Bloom, Ilse;Zhang, Jean;Ward, Kate A. A.;Cooper, Cyrus;Dennison, Elaine M. M.
自我感知骨折风险（SPR）与骨折相关，独立于FRAX计算的风险。为了更好地理解这一点，我们考虑了FRAX算法中未包括的生活方式因素和社会心理因素（社会孤立，自我效能或心理健康状况）是否可以解释SPR与骨折之间的关系。我们研究了来自赫特福德郡队列研究的146名英国社区居住老年人。通过问卷调查评估SPR相对于同龄人的“较低”，“相似”和“较高”。社会隔离进行了评估，使用六项Lubben社会网络量表;自我效能进行了评估，使用缩短的一般自我效能量表（GSE）;心理健康状况进行了评估，使用焦虑/抑郁项目从欧洲生活质量问卷。SPR与既往自我报告骨折的相关性采用逻辑回归进行检查。在中位年龄为83.4（IQR 81.5-85.5）岁的参与者中，54.1%的参与者SPR较低，30.8%相似，15.1%较高; 74.7%报告既往无骨折。当仅调整性别和年龄时，更大的SPR与既往骨折的几率增加相关（OR 1.72，95%CI 1.03-2.87，每个更高的SPR带）。虽然进一步调整社会隔离（1.73，1.04-2.89），自我效能（1.71，1.02-2.85）或心理健康（1.77，1.06-2.97）的个体并没有减弱这种关系，但调整饮食质量和合并症数量的个体却有这种关系。社会隔离，自我效能或心理健康状况的调整并没有削弱SPR和骨折之间的关系。相比之下，FRAX中未包括的生活方式因素，如饮食质量，确实削弱了关系，这表明未来可能的调查领域。
Self-perceived risk of fracture (SPR) is associated with fracture independent of FRAX calculated risk. To understand this better we considered whether lifestyle factors not included in the FRAX algorithm and psychosocial factors (social isolation, self-efficacy, or mental health status) explain the relationship between SPR and fracture. We studied 146 UK community-dwelling older adults from the Hertfordshire Cohort Study. SPR ranked as ‘lower’, ‘similar’ and ‘higher’ relative to others of the same age, was assessed by questionnaire. Social isolation was assessed using the six-item Lubben Social Network Scale; self-efficacy was assessed using a shortened General Self-Efficacy Scale (GSE); mental health status was assessed using the anxiety/depression item from the EuroQoL questionnaire. SPR in relation to previous self-reported fracture was examined using logistic regression. Among participants of median age 83.4 (IQR 81.5–85.5) years, SPR was lower for 54.1% of participants, similar for 30.8%, and higher for 15.1%; 74.7% reported no previous fractures. Greater SPR was associated with increased odds of previous fractures when adjusting for sex and age only (OR 1.72, 95% CI 1.03–2.87, per higher band of SPR). While further individual adjustment for social isolation (1.73, 1.04–2.89), self-efficacy (1.71, 1.02–2.85), or mental health (1.77, 1.06–2.97) did not attenuate the relationship, individual adjustment for diet quality and number of comorbidities did. Adjustment for social isolation, self-efficacy or mental health status did not attenuate the relationship between SPR and fracture. By contrast, lifestyle factors not included in FRAX, such as diet quality, did attenuate relationships, suggesting a possible future area of investigation.
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