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<title xml:lang="en">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)</title>
<author>
<name sortKey="Prieto Alhambra, Daniel" sort="Prieto Alhambra, Daniel" uniqKey="Prieto Alhambra D" first="Daniel" last="Prieto-Alhambra">Daniel Prieto-Alhambra</name>
<affiliation>
<nlm:aff id="A1">Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona; RETICEF, FEDER, ISCIII Madrid; Spain</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A2">Institut Català de la Salut – IDIAP Jordi Gol i Gurina, Barcelona, Spain</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A3">Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Nogues, Xavier" sort="Nogues, Xavier" uniqKey="Nogues X" first="Xavier" last="Nogues">Xavier Nogues</name>
<affiliation>
<nlm:aff id="A1">Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona; RETICEF, FEDER, ISCIII Madrid; Spain</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Javaid, M Kassim" sort="Javaid, M Kassim" uniqKey="Javaid M" first="M Kassim" last="Javaid">M Kassim Javaid</name>
<affiliation>
<nlm:aff id="A3">Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Wyman, Allison" sort="Wyman, Allison" uniqKey="Wyman A" first="Allison" last="Wyman">Allison Wyman</name>
<affiliation>
<nlm:aff id="A4">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Arden, Nigel K" sort="Arden, Nigel K" uniqKey="Arden N" first="Nigel K" last="Arden">Nigel K. Arden</name>
<affiliation>
<nlm:aff id="A3">Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Azagra, Rafael" sort="Azagra, Rafael" uniqKey="Azagra R" first="Rafael" last="Azagra">Rafael Azagra</name>
<affiliation>
<nlm:aff id="A2">Institut Català de la Salut – IDIAP Jordi Gol i Gurina, Barcelona, Spain</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name>
<affiliation>
<nlm:aff id="A3">Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, UK</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A5">MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Adachi, Jonathan D" sort="Adachi, Jonathan D" uniqKey="Adachi J" first="Jonathan D" last="Adachi">Jonathan D. Adachi</name>
<affiliation>
<nlm:aff id="A6">St. Joseph’s Hospital, McMaster University, Hamilton, Ontario, Canada</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Boonen, Steven" sort="Boonen, Steven" uniqKey="Boonen S" first="Steven" last="Boonen">Steven Boonen</name>
<affiliation>
<nlm:aff id="A7">Leuven University Centre for Metabolic Bone Diseases, Division of Geriatric Medicine, Katholieke Universiteit Leuven, Leuven, Belgium</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Chapurlat, Roland D" sort="Chapurlat, Roland D" uniqKey="Chapurlat R" first="Roland D" last="Chapurlat">Roland D. Chapurlat</name>
<affiliation>
<nlm:aff id="A8">Division of Rheumatology, INSERM UMR 1033, Université de Lyon, Hospices Civils de Lyon, Hôpital E Herriot, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Compston, Juliet E" sort="Compston, Juliet E" uniqKey="Compston J" first="Juliet E" last="Compston">Juliet E. Compston</name>
<affiliation>
<nlm:aff id="A9">University of Cambridge School of Clinical Medicine, Addenbrooke’s Hospital, Cambridge, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Gehlbach, Stephen H" sort="Gehlbach, Stephen H" uniqKey="Gehlbach S" first="Stephen H" last="Gehlbach">Stephen H. Gehlbach</name>
<affiliation>
<nlm:aff id="A4">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Greenspan, Susan L" sort="Greenspan, Susan L" uniqKey="Greenspan S" first="Susan L" last="Greenspan">Susan L. Greenspan</name>
<affiliation>
<nlm:aff id="A10">University of Pittsburgh, Pittsburgh, Pennsylvania, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Hooven, Frederick H" sort="Hooven, Frederick H" uniqKey="Hooven F" first="Frederick H" last="Hooven">Frederick H. Hooven</name>
<affiliation>
<nlm:aff id="A4">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Netelenbos, J Coen" sort="Netelenbos, J Coen" uniqKey="Netelenbos J" first="J Coen" last="Netelenbos">J Coen Netelenbos</name>
<affiliation>
<nlm:aff id="A11">Department of Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Pfeilschifter, Johannes" sort="Pfeilschifter, Johannes" uniqKey="Pfeilschifter J" first="Johannes" last="Pfeilschifter">Johannes Pfeilschifter</name>
<affiliation>
<nlm:aff id="A12">Department of Internal Medicine III, Alfried Krupp Krankenhaus, Essen, Germany</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Rossini, Maurizio" sort="Rossini, Maurizio" uniqKey="Rossini M" first="Maurizio" last="Rossini">Maurizio Rossini</name>
<affiliation>
<nlm:aff id="A13">Section of Rheumatology, Department of Medicine, University of Verona, Verona, Italy</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Sambrook, Philip N" sort="Sambrook, Philip N" uniqKey="Sambrook P" first="Philip N" last="Sambrook">Philip N. Sambrook</name>
<affiliation>
<nlm:aff id="A14">University of Sydney-Royal North Shore Hospital, St Leonards, Sydney, New South Wales, Australia</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Silverman, Stuart" sort="Silverman, Stuart" uniqKey="Silverman S" first="Stuart" last="Silverman">Stuart Silverman</name>
<affiliation>
<nlm:aff id="A15">Department of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Siris, Ethel S" sort="Siris, Ethel S" uniqKey="Siris E" first="Ethel S" last="Siris">Ethel S. Siris</name>
<affiliation>
<nlm:aff id="A16">Columbia University Medical Center, New York, New York, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Watts, Nelson B" sort="Watts, Nelson B" uniqKey="Watts N" first="Nelson B" last="Watts">Nelson B. Watts</name>
<affiliation>
<nlm:aff id="A17">Bone Health and Osteoporosis Center, University of Cincinnati, Cincinnati, Ohio, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Diez Perez, Adolfo" sort="Diez Perez, Adolfo" uniqKey="Diez Perez A" first="Adolfo" last="Díez-Pérez">Adolfo Díez-Pérez</name>
<affiliation>
<nlm:aff id="A1">Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona; RETICEF, FEDER, ISCIII Madrid; Spain</nlm:aff>
</affiliation>
</author>
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<idno type="pmc">4886333</idno>
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<idno type="doi">10.1136/annrheumdis-2012-201451</idno>
<date when="2012">2012</date>
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<title xml:lang="en" level="a" type="main">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)</title>
<author>
<name sortKey="Prieto Alhambra, Daniel" sort="Prieto Alhambra, Daniel" uniqKey="Prieto Alhambra D" first="Daniel" last="Prieto-Alhambra">Daniel Prieto-Alhambra</name>
<affiliation>
<nlm:aff id="A1">Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona; RETICEF, FEDER, ISCIII Madrid; Spain</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A2">Institut Català de la Salut – IDIAP Jordi Gol i Gurina, Barcelona, Spain</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A3">Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Nogues, Xavier" sort="Nogues, Xavier" uniqKey="Nogues X" first="Xavier" last="Nogues">Xavier Nogues</name>
<affiliation>
<nlm:aff id="A1">Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona; RETICEF, FEDER, ISCIII Madrid; Spain</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Javaid, M Kassim" sort="Javaid, M Kassim" uniqKey="Javaid M" first="M Kassim" last="Javaid">M Kassim Javaid</name>
<affiliation>
<nlm:aff id="A3">Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Wyman, Allison" sort="Wyman, Allison" uniqKey="Wyman A" first="Allison" last="Wyman">Allison Wyman</name>
<affiliation>
<nlm:aff id="A4">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Arden, Nigel K" sort="Arden, Nigel K" uniqKey="Arden N" first="Nigel K" last="Arden">Nigel K. Arden</name>
<affiliation>
<nlm:aff id="A3">Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Azagra, Rafael" sort="Azagra, Rafael" uniqKey="Azagra R" first="Rafael" last="Azagra">Rafael Azagra</name>
<affiliation>
<nlm:aff id="A2">Institut Català de la Salut – IDIAP Jordi Gol i Gurina, Barcelona, Spain</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name>
<affiliation>
<nlm:aff id="A3">Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, UK</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="A5">MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Adachi, Jonathan D" sort="Adachi, Jonathan D" uniqKey="Adachi J" first="Jonathan D" last="Adachi">Jonathan D. Adachi</name>
<affiliation>
<nlm:aff id="A6">St. Joseph’s Hospital, McMaster University, Hamilton, Ontario, Canada</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Boonen, Steven" sort="Boonen, Steven" uniqKey="Boonen S" first="Steven" last="Boonen">Steven Boonen</name>
<affiliation>
<nlm:aff id="A7">Leuven University Centre for Metabolic Bone Diseases, Division of Geriatric Medicine, Katholieke Universiteit Leuven, Leuven, Belgium</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Chapurlat, Roland D" sort="Chapurlat, Roland D" uniqKey="Chapurlat R" first="Roland D" last="Chapurlat">Roland D. Chapurlat</name>
<affiliation>
<nlm:aff id="A8">Division of Rheumatology, INSERM UMR 1033, Université de Lyon, Hospices Civils de Lyon, Hôpital E Herriot, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Compston, Juliet E" sort="Compston, Juliet E" uniqKey="Compston J" first="Juliet E" last="Compston">Juliet E. Compston</name>
<affiliation>
<nlm:aff id="A9">University of Cambridge School of Clinical Medicine, Addenbrooke’s Hospital, Cambridge, UK</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Gehlbach, Stephen H" sort="Gehlbach, Stephen H" uniqKey="Gehlbach S" first="Stephen H" last="Gehlbach">Stephen H. Gehlbach</name>
<affiliation>
<nlm:aff id="A4">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Greenspan, Susan L" sort="Greenspan, Susan L" uniqKey="Greenspan S" first="Susan L" last="Greenspan">Susan L. Greenspan</name>
<affiliation>
<nlm:aff id="A10">University of Pittsburgh, Pittsburgh, Pennsylvania, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Hooven, Frederick H" sort="Hooven, Frederick H" uniqKey="Hooven F" first="Frederick H" last="Hooven">Frederick H. Hooven</name>
<affiliation>
<nlm:aff id="A4">Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Netelenbos, J Coen" sort="Netelenbos, J Coen" uniqKey="Netelenbos J" first="J Coen" last="Netelenbos">J Coen Netelenbos</name>
<affiliation>
<nlm:aff id="A11">Department of Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Pfeilschifter, Johannes" sort="Pfeilschifter, Johannes" uniqKey="Pfeilschifter J" first="Johannes" last="Pfeilschifter">Johannes Pfeilschifter</name>
<affiliation>
<nlm:aff id="A12">Department of Internal Medicine III, Alfried Krupp Krankenhaus, Essen, Germany</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Rossini, Maurizio" sort="Rossini, Maurizio" uniqKey="Rossini M" first="Maurizio" last="Rossini">Maurizio Rossini</name>
<affiliation>
<nlm:aff id="A13">Section of Rheumatology, Department of Medicine, University of Verona, Verona, Italy</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Sambrook, Philip N" sort="Sambrook, Philip N" uniqKey="Sambrook P" first="Philip N" last="Sambrook">Philip N. Sambrook</name>
<affiliation>
<nlm:aff id="A14">University of Sydney-Royal North Shore Hospital, St Leonards, Sydney, New South Wales, Australia</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Silverman, Stuart" sort="Silverman, Stuart" uniqKey="Silverman S" first="Stuart" last="Silverman">Stuart Silverman</name>
<affiliation>
<nlm:aff id="A15">Department of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Siris, Ethel S" sort="Siris, Ethel S" uniqKey="Siris E" first="Ethel S" last="Siris">Ethel S. Siris</name>
<affiliation>
<nlm:aff id="A16">Columbia University Medical Center, New York, New York, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Watts, Nelson B" sort="Watts, Nelson B" uniqKey="Watts N" first="Nelson B" last="Watts">Nelson B. Watts</name>
<affiliation>
<nlm:aff id="A17">Bone Health and Osteoporosis Center, University of Cincinnati, Cincinnati, Ohio, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Diez Perez, Adolfo" sort="Diez Perez, Adolfo" uniqKey="Diez Perez A" first="Adolfo" last="Díez-Pérez">Adolfo Díez-Pérez</name>
<affiliation>
<nlm:aff id="A1">Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona; RETICEF, FEDER, ISCIII Madrid; Spain</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Annals of the rheumatic diseases</title>
<idno type="ISSN">0003-4967</idno>
<idno type="eISSN">1468-2060</idno>
<imprint>
<date when="2012">2012</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
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<front>
<div type="abstract" xml:lang="en">
<sec id="S1">
<title>Objective</title>
<p id="P1">Patients with osteoarthritis have increased bone mass, but no decrease in fractures. We studied the association between self-reported osteoarthritis and incident falls and fractures in postmenopausal women.</p>
</sec>
<sec id="S2">
<title>Methods</title>
<p id="P2">GLOW 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 osteoarthritic 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. 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.</p>
</sec>
<sec id="S3">
<title>Results</title>
<p id="P3">Of 51 386 women followed for a median of 2.9 (interquartile range 2.1 to 3.0) years, 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).</p>
</sec>
<sec id="S4">
<title>Conclusion</title>
<p id="P4">Postmenopausal women with self-reported osteoarthritis have a 20% increased risk of fracture and experience 25% more falls than osteoarthritis-free peers. Our data suggest that increased falls are the causal pathway of the association between osteoarthritis and fractures.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-journal-id">0372355</journal-id>
<journal-id journal-id-type="pubmed-jr-id">640</journal-id>
<journal-id journal-id-type="nlm-ta">Ann Rheum Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">Ann. Rheum. Dis.</journal-id>
<journal-title-group>
<journal-title>Annals of the rheumatic diseases</journal-title>
</journal-title-group>
<issn pub-type="ppub">0003-4967</issn>
<issn pub-type="epub">1468-2060</issn>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">22730372</article-id>
<article-id pub-id-type="pmc">4886333</article-id>
<article-id pub-id-type="doi">10.1136/annrheumdis-2012-201451</article-id>
<article-id pub-id-type="manuscript">NIHMS786586</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>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)</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Prieto-Alhambra</surname>
<given-names>Daniel</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Nogues</surname>
<given-names>Xavier</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Javaid</surname>
<given-names>M Kassim</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wyman</surname>
<given-names>Allison</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Arden</surname>
<given-names>Nigel K</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Azagra</surname>
<given-names>Rafael</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Cooper</surname>
<given-names>Cyrus</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Adachi</surname>
<given-names>Jonathan D</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Boonen</surname>
<given-names>Steven</given-names>
</name>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chapurlat</surname>
<given-names>Roland D</given-names>
</name>
<xref ref-type="aff" rid="A8">8</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Compston</surname>
<given-names>Juliet E</given-names>
</name>
<xref ref-type="aff" rid="A9">9</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Gehlbach</surname>
<given-names>Stephen H</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Greenspan</surname>
<given-names>Susan L</given-names>
</name>
<xref ref-type="aff" rid="A10">10</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hooven</surname>
<given-names>Frederick H</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Netelenbos</surname>
<given-names>J Coen</given-names>
</name>
<xref ref-type="aff" rid="A11">11</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Pfeilschifter</surname>
<given-names>Johannes</given-names>
</name>
<xref ref-type="aff" rid="A12">12</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Rossini</surname>
<given-names>Maurizio</given-names>
</name>
<xref ref-type="aff" rid="A13">13</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Sambrook</surname>
<given-names>Philip N</given-names>
</name>
<xref ref-type="aff" rid="A14">14</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Silverman</surname>
<given-names>Stuart</given-names>
</name>
<xref ref-type="aff" rid="A15">15</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Siris</surname>
<given-names>Ethel S</given-names>
</name>
<xref ref-type="aff" rid="A16">16</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Watts</surname>
<given-names>Nelson B</given-names>
</name>
<xref ref-type="aff" rid="A17">17</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Díez-Pérez</surname>
<given-names>Adolfo</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
</contrib-group>
<aff id="A1">
<label>1</label>
Hospital del Mar-IMIM-Autonomous University of Barcelona, Barcelona; RETICEF, FEDER, ISCIII Madrid; Spain</aff>
<aff id="A2">
<label>2</label>
Institut Català de la Salut – IDIAP Jordi Gol i Gurina, Barcelona, Spain</aff>
<aff id="A3">
<label>3</label>
Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford, UK</aff>
<aff id="A4">
<label>4</label>
Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA</aff>
<aff id="A5">
<label>5</label>
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK</aff>
<aff id="A6">
<label>6</label>
St. Joseph’s Hospital, McMaster University, Hamilton, Ontario, Canada</aff>
<aff id="A7">
<label>7</label>
Leuven University Centre for Metabolic Bone Diseases, Division of Geriatric Medicine, Katholieke Universiteit Leuven, Leuven, Belgium</aff>
<aff id="A8">
<label>8</label>
Division of Rheumatology, INSERM UMR 1033, Université de Lyon, Hospices Civils de Lyon, Hôpital E Herriot, Lyon, France</aff>
<aff id="A9">
<label>9</label>
University of Cambridge School of Clinical Medicine, Addenbrooke’s Hospital, Cambridge, UK</aff>
<aff id="A10">
<label>10</label>
University of Pittsburgh, Pittsburgh, Pennsylvania, USA</aff>
<aff id="A11">
<label>11</label>
Department of Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands</aff>
<aff id="A12">
<label>12</label>
Department of Internal Medicine III, Alfried Krupp Krankenhaus, Essen, Germany</aff>
<aff id="A13">
<label>13</label>
Section of Rheumatology, Department of Medicine, University of Verona, Verona, Italy</aff>
<aff id="A14">
<label>14</label>
University of Sydney-Royal North Shore Hospital, St Leonards, Sydney, New South Wales, Australia</aff>
<aff id="A15">
<label>15</label>
Department of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA</aff>
<aff id="A16">
<label>16</label>
Columbia University Medical Center, New York, New York, USA</aff>
<aff id="A17">
<label>17</label>
Bone Health and Osteoporosis Center, University of Cincinnati, Cincinnati, Ohio, USA</aff>
<author-notes>
<corresp id="cor1">
<bold>Correspondence to</bold>
Adolfo Díez-Pérez, Departament de Medicina Interna, Parc de Salut Mar, C/Doctor Aiguader, 88 08003, Barcelona, Spain;
<email>ADiez@parcdesalutmar.cat</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted">
<day>14</day>
<month>5</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>23</day>
<month>6</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="ppub">
<month>6</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>31</day>
<month>5</month>
<year>2016</year>
</pub-date>
<volume>72</volume>
<issue>6</issue>
<fpage>911</fpage>
<lpage>917</lpage>
<pmc-comment>elocation-id from pubmed: 10.1136/annrheumdis-2012-201451</pmc-comment>
<abstract>
<sec id="S1">
<title>Objective</title>
<p id="P1">Patients with osteoarthritis have increased bone mass, but no decrease in fractures. We studied the association between self-reported osteoarthritis and incident falls and fractures in postmenopausal women.</p>
</sec>
<sec id="S2">
<title>Methods</title>
<p id="P2">GLOW 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 osteoarthritic 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. 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.</p>
</sec>
<sec id="S3">
<title>Results</title>
<p id="P3">Of 51 386 women followed for a median of 2.9 (interquartile range 2.1 to 3.0) years, 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).</p>
</sec>
<sec id="S4">
<title>Conclusion</title>
<p id="P4">Postmenopausal women with self-reported osteoarthritis have a 20% increased risk of fracture and experience 25% more falls than osteoarthritis-free peers. Our data suggest that increased falls are the causal pathway of the association between osteoarthritis and fractures.</p>
</sec>
</abstract>
<kwd-group>
<kwd>Osteoporosis</kwd>
<kwd>Osteoarthritis</kwd>
<kwd>Fractures</kwd>
<kwd>Bone</kwd>
<kwd>Accidental Falls</kwd>
<kwd>Epidemiology</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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