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Abstract  The Japanese Society for Bone and Mineral Research developed the Japanese Osteoporosis Quality of Life Questionnaire (JOQOL) to evaluate the disease-specific Health-Related QOL, which is specific for osteoporosis of Japanese patients. JOQOL was revised in 2000; it consisted of 38 items with the scale graded from 0 to 4 and a total full score of 152. To elucidate the reliability and validity of the revised JOQOL, we enrolled 193 postmenopausal women as subjects and diagnosed them as having osteoporosis or osteopenia. The mean age of the subjects was 68.2 ± 8 years; 58 subjects (30.1%) had at least one vertebral fracture. Among them, 83 patients were retested for reliability. The mean lapse from the time of test to that of retest was 23.7(±9.5) days. The subjects were questioned using the JOQOL, Medical Outcomes Study Short Form 36 (SF-36), along with questions on subjects’ characteristics and their ADL. The JOQOL scores at the test and the retest were significantly correlated (r = 0.973) without significant difference between their mean scores. All the JOQOL items showed significant correlations at the test and the retest (Kendall’s τ = 0.599–0.947). Cronbach’s alpha coefficient of JOQOL was 0.918. These results proved the high reliability of JOQOL. The JOQOL score showed negative correlation with age (r = −0.183). The subjects with vertebral fractures had significantly lower JOQOL scores than the subjects without fractures. The JOQOL showed a significant correlation with all the scores in each domain of eight of SF-36 (r = 0.350–0.839). These results were consistent with that of the preceding study. It is concluded that the reliability and the validity of JOQOL were demonstrated in this study. [ABSTRACT FROM AUTHOR]

We conducted a prospective, randomized, multicenter, open-label 2-year trial with 76 postmenopausal women aged ≥60 years with low (T-score less than −1) lumbar bone mineral density (BMD). The hormone replacement therapy (HRT) group received a low dose of conjugated estrogen (CEE) at a dose of 0.31mg/day ± medroxyprogesterone acetate (MPA) 2.5mg/day. Group HRT/D received the same dose of HRT together with alfacalcidol in a daily dose of 1.0µg/day. Changes in lumbar BMD measured by dual energy X-ray absorptiometry (DXA) were followed every 6 months for 2 years. The lumbar BMD of group HRT increased 3.37% [95% confidence interval (CI) 1.6%–5.2%], 4.00% (95%CI 1.6%–6.4%), and 2.32% (95%CI −0.7% to 5.3%) at 12, 18, and 24 months, respectively, when the baseline value was taken as 0%. Lumbar BMD of group HRT/D showed a significant increase beyond 6 months. The percent increases for this group at 6, 12, 18, and 24 months were 6.18 (95%CI 1.3%–6.6%), 6.18% (95%CI 3.9%–8.5%), 7.17% (95%CI 4.3%–10.0%), and 8.75% (95%CI 6.0%–11.5%), respectively. In addition, there was a significant difference in the changes of the lumbar BMD between the two groups at 24 months, suggesting that the combination of HRT and alfacalcidol is more effective than HRT alone in terms of the BMD effect. This study is the first prospective trial demonstrating an additive effect of alfacalcidol on lumbar BMD in postmenopausal women receiving low-dose HRT. It suggests that the combination therapy can be considered to be a promising mode of treatment for bone loss after menopause. [ABSTRACT FROM AUTHOR]