Skip to main content
Top
Published in: Osteoporosis International 2/2015

01-02-2015 | Original Article

Self-perceived facture risk: factors underlying women’s perception of risk for osteoporotic fractures: the Risk-Stratified Osteoporosis Strategy Evaluation study (ROSE)

Authors: M. J. Rothmann, J. Ammentorp, M. Bech, J. Gram, O. W. Rasmussen, R. Barkmann, C. C. Glüer, A. P. Hermann

Published in: Osteoporosis International | Issue 2/2015

Login to get access

Abstract

Summary

This Danish cross-sectional study (n = 20,905) showed that women aged 65–81 years generally underestimated fracture risk compared to absolute risk estimated by the FRAX® algorithm. Significant association was found between risk factors (e.g., previous fracture, parental hip fracture, and self-rated heath) and self-perceived fracture risk. Although women recognized the importance of some fracture risk factors, a number of significant risk factors appeared to be less well known.

Introduction

The aim of this study is to investigate women’s self-perceived fracture risk and potential factors associated with this and to compare self-perceived risk with absolute fracture risk estimated by FRAX® in women aged 65–80 years.

Methods

Data from 20,905 questionnaires from the ROSE study were analyzed. The questionnaire included 25 items on osteoporosis, risk factors for fractures, and self-perceived risk of fractures and enabled calculation of absolute fracture risk by FRAX®. Data were analyzed using bivariate tests and regression models.

Results

Women generally underestimated their fracture risk compared to absolute risk estimated by FRAX®. Women with risk factors for facture estimated their fracture risk significantly higher than their peers. No correlation between self-perceived risk and absolute risk was found. The ordered logistic regression model showed a significant association between high self-perceived fracture risk and previous fragility fracture, parental hip fracture, falls, self-rated heath, conditions related to secondary osteoporosis, and inability to do housework.

Conclusions

These women aged 65–81 years underestimated their risk of fracture. However, they did seem to have an understanding of the importance of some risk factors such as previous fractures, parental hip fracture and falls. Risk communication is a key element in fracture prevention and should have greater focus on less well-known risk factors. Furthermore, it is important to acknowledge that risk perception is not based solely on potential risk factors but is also affected by experiences from everyday life to personal history.
Literature
1.
go back to reference Johnell O, Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(Suppl 2):S3–S7PubMedCrossRef Johnell O, Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(Suppl 2):S3–S7PubMedCrossRef
2.
go back to reference Kanis JA, Burlet N, Cooper C, Delmas PD, Reginster JY, Borgstrom F, Rizzoli R (2008) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 19:399–428PubMedCentralPubMedCrossRef Kanis JA, Burlet N, Cooper C, Delmas PD, Reginster JY, Borgstrom F, Rizzoli R (2008) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 19:399–428PubMedCentralPubMedCrossRef
3.
go back to reference Brenneman SK, Barrett-Connor E, Sajjan S, Markson LE, Siris ES (2006) Impact of recent fracture on health-related quality of life in postmenopausal women. J Bone Miner Res 21:809–16PubMedCrossRef Brenneman SK, Barrett-Connor E, Sajjan S, Markson LE, Siris ES (2006) Impact of recent fracture on health-related quality of life in postmenopausal women. J Bone Miner Res 21:809–16PubMedCrossRef
4.
go back to reference Vestergaard P, Rejnmark L, Mosekilde L (2007) Increased mortality in patients with a hip fracture-effect of pre-morbid conditions and post-fracture complications. Osteoporos Int 18:1583–93PubMedCrossRef Vestergaard P, Rejnmark L, Mosekilde L (2007) Increased mortality in patients with a hip fracture-effect of pre-morbid conditions and post-fracture complications. Osteoporos Int 18:1583–93PubMedCrossRef
5.
go back to reference Kanis JA, Johansson H, Oden A, McCloskey EV (2009) Assessment of fracture risk. Eur J Radiol 71:392–97PubMedCrossRef Kanis JA, Johansson H, Oden A, McCloskey EV (2009) Assessment of fracture risk. Eur J Radiol 71:392–97PubMedCrossRef
6.
go back to reference Rubin KH, Abrahamsen B, Hermann AP, Bech M, Gram J, Brixen K (2011) Fracture risk assessed by Fracture Risk Assessment Tool (FRAX) compared with fracture risk derived from population fracture rates. Scand J Public Health 39:312–18 Rubin KH, Abrahamsen B, Hermann AP, Bech M, Gram J, Brixen K (2011) Fracture risk assessed by Fracture Risk Assessment Tool (FRAX) compared with fracture risk derived from population fracture rates. Scand J Public Health 39:312–18
7.
go back to reference Vestergaard P, Rejnmark L, Mosekilde L (2005) Osteoporosis is markedly underdiagnosed: a nationwide study from Denmark. Osteoporos Int 16:134–41PubMedCrossRef Vestergaard P, Rejnmark L, Mosekilde L (2005) Osteoporosis is markedly underdiagnosed: a nationwide study from Denmark. Osteoporos Int 16:134–41PubMedCrossRef
9.
go back to reference Gerend MA, Erchull MJ, Aiken LS, Maner JK (2006) Reasons and risk: factors underlying women’s perceptions of susceptibility to osteoporosis. Maturitas 55:227–37PubMedCrossRef Gerend MA, Erchull MJ, Aiken LS, Maner JK (2006) Reasons and risk: factors underlying women’s perceptions of susceptibility to osteoporosis. Maturitas 55:227–37PubMedCrossRef
10.
go back to reference Gerend MA, Aiken LS, West SG, Erchull MJ (2004) Beyond medical risk: investigating the psychological factors underlying women’s perceptions of susceptibility to breast cancer, heart disease, and osteoporosis. Health Psychol 23:247–58PubMedCrossRef Gerend MA, Aiken LS, West SG, Erchull MJ (2004) Beyond medical risk: investigating the psychological factors underlying women’s perceptions of susceptibility to breast cancer, heart disease, and osteoporosis. Health Psychol 23:247–58PubMedCrossRef
11.
go back to reference Gerend MA, Aiken LS, West SG (2004) Personality factors in older women’s perceived susceptibility to diseases of aging. Health Psychol 23:247–58PubMedCrossRef Gerend MA, Aiken LS, West SG (2004) Personality factors in older women’s perceived susceptibility to diseases of aging. Health Psychol 23:247–58PubMedCrossRef
12.
go back to reference Skolbekken JA, Osterlie W, Forsmo S (2008) Brittle bones, pain and fractures–lay constructions of osteoporosis among Norwegian women attending the Nord-Trondelag Health Study (HUNT). Soc Sci Med 66:2562–72PubMedCrossRef Skolbekken JA, Osterlie W, Forsmo S (2008) Brittle bones, pain and fractures–lay constructions of osteoporosis among Norwegian women attending the Nord-Trondelag Health Study (HUNT). Soc Sci Med 66:2562–72PubMedCrossRef
13.
go back to reference Reventlow S, Bang H (2006) Brittle bones: ageing or threat of disease exploring women’s cultural models of osteoporosis. Scand J Public Health 34:320–326PubMedCrossRef Reventlow S, Bang H (2006) Brittle bones: ageing or threat of disease exploring women’s cultural models of osteoporosis. Scand J Public Health 34:320–326PubMedCrossRef
14.
go back to reference Giangregorio L, Dolovich L, Cranney A, Adili A, Debeer J, Papaioannou A, Thabane L, Adachi JD (2009) Osteoporosis risk perceptions among patients who have sustained a fragility fracture. Patient Educ Couns 74:213–20PubMedCrossRef Giangregorio L, Dolovich L, Cranney A, Adili A, Debeer J, Papaioannou A, Thabane L, Adachi JD (2009) Osteoporosis risk perceptions among patients who have sustained a fragility fracture. Patient Educ Couns 74:213–20PubMedCrossRef
15.
go back to reference Siris ES, Gehlbach S, Adachi JD, Boonen S, Chapurlat RD, Compston JE, Cooper C, Delmas P, Diez-Perez A, Hooven FH, Lacroix AZ, Netelenbos JC, Pfeilschifter J, Rossini M, Roux C, Saag KG, Sambrook P, Silverman S, Watts NB, Wyman A, Greenspan SL (2010) Failure to perceive increased risk of fracture in women 55 years and older: the Global Longitudinal Study of Osteoporosis in Women (GLOW). Osteoporos Int 22:27–35 Siris ES, Gehlbach S, Adachi JD, Boonen S, Chapurlat RD, Compston JE, Cooper C, Delmas P, Diez-Perez A, Hooven FH, Lacroix AZ, Netelenbos JC, Pfeilschifter J, Rossini M, Roux C, Saag KG, Sambrook P, Silverman S, Watts NB, Wyman A, Greenspan SL (2010) Failure to perceive increased risk of fracture in women 55 years and older: the Global Longitudinal Study of Osteoporosis in Women (GLOW). Osteoporos Int 22:27–35
16.
go back to reference Giangregorio L, Papaioannou A, Thabane L, Debeer J, Cranney A, Dolovich L, Adili A, Adachi JD (2008) Do patients perceive a link between a fragility fracture and osteoporosis? BMC Musculoskelet Disord 9:38PubMedCentralPubMedCrossRef Giangregorio L, Papaioannou A, Thabane L, Debeer J, Cranney A, Dolovich L, Adili A, Adachi JD (2008) Do patients perceive a link between a fragility fracture and osteoporosis? BMC Musculoskelet Disord 9:38PubMedCentralPubMedCrossRef
17.
go back to reference Phillipov G, Phillips PJ, Leach G, Taylor AW (1998) Public perceptions and self-reported prevalence of osteoporosis in South Australia. Osteoporos Int 8:552–56PubMedCrossRef Phillipov G, Phillips PJ, Leach G, Taylor AW (1998) Public perceptions and self-reported prevalence of osteoporosis in South Australia. Osteoporos Int 8:552–56PubMedCrossRef
18.
go back to reference Rubin KH, Friis-Holmberg T, Rothmann MJ, Høiberg M, Barkmann R, Gram J, Hermann AP, Bech M, Rasmussen OW, Glüer CC, Brixen KT. The Risk-stratified Osteoporosis Strategy Evaluation study (ROSE): a randomised prospective population-based study. (in press) Rubin KH, Friis-Holmberg T, Rothmann MJ, Høiberg M, Barkmann R, Gram J, Hermann AP, Bech M, Rasmussen OW, Glüer CC, Brixen KT. The Risk-stratified Osteoporosis Strategy Evaluation study (ROSE): a randomised prospective population-based study. (in press)
19.
go back to reference Kanis JA, Borgstrom F, De LC, Johansson H, Johnell O, Jonsson B, Oden A, Zethraeus N, Pfleger B, Khaltaev N (2005) Assessment of fracture risk. Osteoporos Int 16:581–89PubMedCrossRef Kanis JA, Borgstrom F, De LC, Johansson H, Johnell O, Jonsson B, Oden A, Zethraeus N, Pfleger B, Khaltaev N (2005) Assessment of fracture risk. Osteoporos Int 16:581–89PubMedCrossRef
20.
go back to reference Williams R (2006) Generalized ordered logit/partial proportional odds models for ordinal dependent variables. Stata J 6:58–82 Williams R (2006) Generalized ordered logit/partial proportional odds models for ordinal dependent variables. Stata J 6:58–82
21.
go back to reference Reventlow SD, Hvas L, Malterud K (2006) Making the invisible body visible. Bone scans, osteoporosis and women’s bodily experiences. Soc Sci Med 62:2720–2731PubMedCrossRef Reventlow SD, Hvas L, Malterud K (2006) Making the invisible body visible. Bone scans, osteoporosis and women’s bodily experiences. Soc Sci Med 62:2720–2731PubMedCrossRef
22.
go back to reference Schousboe JT (2013) Adherence with medications used to treat osteoporosis: behavioral insights. Curr Osteoporos Rep 11(1):21–9PubMedCrossRef Schousboe JT (2013) Adherence with medications used to treat osteoporosis: behavioral insights. Curr Osteoporos Rep 11(1):21–9PubMedCrossRef
23.
go back to reference Bridges MJ, Ruddick S (2010) Can self-reported height and weight be used to calculate 10 year risk of osteoporotic fracture? J Nutr Health Aging 14:611–13PubMedCrossRef Bridges MJ, Ruddick S (2010) Can self-reported height and weight be used to calculate 10 year risk of osteoporotic fracture? J Nutr Health Aging 14:611–13PubMedCrossRef
Metadata
Title
Self-perceived facture risk: factors underlying women’s perception of risk for osteoporotic fractures: the Risk-Stratified Osteoporosis Strategy Evaluation study (ROSE)
Authors
M. J. Rothmann
J. Ammentorp
M. Bech
J. Gram
O. W. Rasmussen
R. Barkmann
C. C. Glüer
A. P. Hermann
Publication date
01-02-2015
Publisher
Springer London
Published in
Osteoporosis International / Issue 2/2015
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-014-2936-6

Other articles of this Issue 2/2015

Osteoporosis International 2/2015 Go to the issue