Accuracy of patient-reported height loss and risk factors for height loss among postmenopausal women

Abstract

Background: Since loss of height may indicate vertebral fracture, the accuracy of the information on height is relevant for clinical practice. We undertook this study to compare reported and measured loss of height among postmenopausal women in a primary care setting. We also analyzed the determinants of this height loss. Methods: In an observational study conducted between December 2007 and May 2008, we asked 1779 randomly selected general practitioners to recruit the first five female patients who were more than 60 years of age, regardless of the reason for the consultation. Using a questionnaire, physicians collected data on demographic and clinical variables, history of osteoporosis and current anti-osteoporotic treatment. We used three assessments of height: tallest height in early adulthood recalled by the patient, estimated current height reported by the patient at the visit and current measured height. We defined loss of height as the difference between the patient's tallest recalled height and her current measured height. Results: A total of 8610 patients were included in the analysis; the mean age was 70.9 (standard deviation [SD] 7.2) years. The mean loss of height was 4.5 cm. The mean current reported height was 2.1 (SD 2.5) cm lower than the tallest recalled height and 2.4 (SD 2.6) cm lower than the measured current height. The best predictors of a loss of height of 3 cm or more were age (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.08-1.10), previous vertebral fracture (OR 1.49, 95% CI 1.16-1.91), previous nonvertebral fracture (OR 1.26, 95% CI 1.06-1.51), thoracic kyphosis (OR 2.07, 95% CI 1.69-2.55), scoliosis (OR 1.35, 95% CI 1.12-1.63), back pain (OR 1.22, 95% CI 1.07-1.39) and osteoporosis (OR 1.39, 95% CI 1.20-1.60). Interpretation: Our study showed that the patients' estimated current height was not correct, with a mean difference of -2.5 cm from the current measured height. The mean height loss was 4.5 cm. Previous vertebral fracture and thoracic kyphosis were strong determinants of the height loss. © 2010 Canadian Medical Association.