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Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2022

Open Access 01-12-2022 | Osteoarthrosis | Original Article

Multidimensional prognostic index and the risk of fractures: an 8-year longitudinal cohort study in the Osteoarthritis Initiative

Authors: Nicola Veronese, Lee Smith, Ekaterini Zigoura, Mario Barbagallo, Ligia J. Dominguez, Antonella Barone, Alberto Cella, Cyrus Cooper, Renè Rizzoli, Jean-Yves Reginster, Stefania Maggi, Alberto Pilotto

Published in: Archives of Osteoporosis | Issue 1/2022

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Abstract

Summary

In this longitudinal study, with a follow-up of 8 years, multidimensional prognostic index (MPI), a product of the comprehensive geriatric assessment, significantly predicted the onset of fractures in older people affected by knee osteoarthritis.

Purpose

Frailty may be associated with higher fracture risk, but limited research has been carried out using a multidimensional approach to frailty assessment and diagnosis. The present research aimed to investigate whether the MPI, based on comprehensive geriatric assessment (CGA), is associated with the risk of fractures in the Osteoarthritis Initiative (OAI) study.

Methods

Community-dwellers affected by knee OA or at high risk for this condition were followed-up for 8 years. A standardized CGA including information on functional, nutritional, mood, comorbidity, medication, quality of life, and co-habitation status was used to calculate the MPI. Fractures were diagnosed using self-reported information. Cox’s regression analysis was carried out and results are reported as hazard ratios (HRs), with their 95% confidence intervals (CIs), adjusted for potential confounders.

Results

The sample consisted of 4024 individuals (mean age 61.0 years, females = 59.0%). People with incident fractures had a significant higher MPI baseline value than those without (0.42 ± 0.18 vs. 0.40 ± 0.17). After adjusting for several potential confounders, people with an MPI over 0.66 (HR = 1.49; 95%CI: 1.11–2.00) experienced a higher risk of fractures. An increase in 0.10 point in MPI score corresponded to an increase in fracture risk of 4% (HR = 1.04; 95%CI: 1.008–1.07). Higher MPI values were also associated with a higher risk of non-vertebral clinical fractures.

Conclusion

Higher MPI values at baseline were associated with an increased risk of fractures, reinforcing the importance of CGA in predicting fractures in older people affected by knee OA.
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Metadata
Title
Multidimensional prognostic index and the risk of fractures: an 8-year longitudinal cohort study in the Osteoarthritis Initiative
Authors
Nicola Veronese
Lee Smith
Ekaterini Zigoura
Mario Barbagallo
Ligia J. Dominguez
Antonella Barone
Alberto Cella
Cyrus Cooper
Renè Rizzoli
Jean-Yves Reginster
Stefania Maggi
Alberto Pilotto
Publication date
01-12-2022
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2022
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-021-01015-3

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