Purpose To examine changes in health-related quality of life (HRQoL) and functional ability associated with incident vertebral deformities (VD) in community dwelling older adults over 10.7 years.
Methods Participants (n=780) underwent whole-body dual-energy X-ray absorptiometry (DXA) scans at baseline, 2.5, 5.1 and 10.7 years later. VD was defined as ≥20% reduction in anterior height relative to posterior height of vertebrae from T4-L4. An incident VD was defined as new VD at any follow-up visit. Assessment of Quality of Life (AQoL-4D) questionnaire and Health Assessment Questionnaire Disability Index (HAQ-DI) were used to assess HRQoL and functional impairment. Change in AQoL and HAQ-DI scores associated with incident VD was analysed using multilevel mixed-effects linear regression and log binomial regression. Log binomial regression was also used to examine effects of severity and number of VD.
Results Incidence of VD was 53% over 10.7 years. Incident VD were associated with annual reduction in AQoL utility score (β=-0.003,95%CI -0.01 - -0.001) in women, but not men. Incident VD increased the risk of clinically significant reduction in HAQ-DI among women (RR=1.50,95%CI 1.02-2.20), not men (RR=1.24,95%CI 0.74-2.09). Women showed increased risk of functional impairment with mild VD (RR=1.61,95%CI 1.05-2.46), but not moderate or severe (RR=1.36,95%CI 0.83-2.21). There was a dose-response relationship with increasing number of incident VD and risk of functional impairment and among women (RR=1.19 (95%CI 0.77-1.85) for one, RR=2.08 (95%CI 1.25-3.46) for two and RR=2.30 (95%CI 1.03-5.11) for ≥3VD), but not men for one (RR=1.10(95%CI 0.58-2.09) for one, RR=1.70 (95%CI 0.89-3.25) for two and RR=1.10 (95%CI 0.41-2.99) for ≥3VD).
Conclusions Incident VD are associated with clinically significant functional impairment and worsening HRQoL in older women, but not men. Increasing number of incident VDs were associated with increased risk of functional impairment in women, but not men.