Factors associated with functional decline in hand and hip/knee osteoarthritis after one year: data from a population‐based study

Public Health and primary careGeriatrics in primary car

How hand osteoarthritis, comorbidity and pain interact to determine functional limitation in older people: observations from the EPOSA study

To examine the role of comorbidity and pain in the associations existing between hand osteoarthritis (OA) and self-reported as well as performance-based physical function in a general elderly population.The data of 2942 participants in the European Project on OSteoArthritis, aged 65 to 85 years, belonging to 6 European cohorts (Germany, Italy, the Netherlands, Spain, Sweden and the United Kingdom) were studied. Outcomes considered self-reported physical functioning subscale scores determined using the Australian/Canadian OA Hand Index (AUSCAN) and a performance-based muscle strength measure, which was quantified using a strain-gauge dynamometer.In the association between hand OA and self-reported as well as performance-based functional limitations, comorbidity was not a confounder and the role of pain as a mediator was instead confirmed. Anxiety, depression, stroke and osteoporosis were associated with more impaired AUSCAN scores. Depression and osteoporosis were associated with less grip strength.Study results have demonstrated that although comorbidity was decidedly and independently associated with hand functional limitation, it has no effect on the hand OA-physical function relationship. Hand OA was found to be associated with self-reported as well as with performance-based physical function impairment; the association was found to be partially mediated by pain, which reduces its impact. This article is protected by copyright. All rights reserved

The Influence of Weather Conditions on Joint Pain in Older People with Osteoarthritis: Results from the European Project on OSteoArthritis

Objective. This study examined whether daily weather conditions, 3-day average weather conditions, and changes in weather conditions influence joint pain in older people with osteoarthritis (OA) in 6 European countries. Methods. Data from the population-based European Project on OSteoArthritis were used. The American College of Rheumatology classification criteria were used to diagnose OA in older people (65-85 yrs). After the baseline interview, at 6 months, and after the 12-18 months followup interview, joint pain was assessed using 2-week pain calendars. Daily values for temperature, precipitation, atmospheric pressure, relative humidity, and wind speed were obtained from local weather stations. Multilevel regression modelling was used to examine the pain-weather associations, adjusted for several confounders. Results. The study included 810 participants with OA in the knee, hand, and/or hip. After adjustment, there were significant associations of joint pain with daily average humidity (B = 0.004, p < 0.01) and 3-day average humidity (B = 0.004, p = 0.01). A significant interaction effect was found between daily average humidity and temperature on joint pain. The effect of humidity on pain was stronger in relatively cold weather conditions. Changes in weather variables between 2 consecutive days were not significantly associated with reported joint pain. Conclusion. The associations between pain and daily average weather conditions suggest that a causal relationship exist between joint pain and weather variables, but the associations between day-to-day weather changes and pain do not confirm causation. Knowledge about the relationship between joint pain in OA and weather may help individuals with OA, physicians, and therapists to better understand and manage fluctuations in pain

Within-person pain variability and physical activity in older adults with osteoarthritis from six European countries

BackgroundThis study examines the association of both pain severity and within-person pain variability with physical activity (PA) in older adults with osteoarthritis (OA).MethodsData from the European Project on OSteoArthritis were used. At baseline, clinical classification criteria of the American College of Rheumatology were used to diagnose OA in older adults (65-85years). At baseline and 12-18months follow-up, frequency and duration of participation in the activities walking, cycling, gardening, light and heavy household tasks, and sports activities were assessed with the Longitudinal Aging Study Amsterdam Physical Activity Questionnaire. Physical activity was calculated in kcal/day, based on frequency, duration, body weight and the metabolic equivalent of each activity performed. At baseline and 12-18months follow-up, pain severity was assessed using the pain subscales of the Western Ontario and McMaster Universities OA Index and the Australian/Canadian Hand OA Index. Within-person pain variability was assessed using two-week pain calendars that were completed at baseline, 6months follow-up and 12-18months follow-up.ResultsOf all 669 participants, 70.0% were women. Sex-stratified multiple linear regression analyses showed that greater pain severity at baseline was cross-sectionally associated with less PA in women (Ratio=0.95, 95% CI=0.90-0.99), but not in men (Ratio=0.99, 95% CI=0.85-1.15). The longitudinal analyses showed a statistically significant inverse association between pain severity at baseline and PA at follow-up in women (Ratio=0.94, 95% CI=0.89-0.99), but not in men (Ratio=1.00, 95% CI=0.87-1.11). Greater pain variability over 12-18months was associated with more PA at follow-up in men (Ratio=1.18, 95% CI=1.01-1.38), but not in women (Ratio=0.94, 95% CI=0.86-1.03).ConclusionsGreater pain severity and less pain variability are associated with less PA in older adults with OA. These associations are different for men and women. The observed sex differences in the various associations should be studied in more detail and need replication in future research.Experimentele farmacotherapi

Relationships between physical performance and knee and hip osteoarthritis: findings from the European Project on Osteoarthritis (EPOSA).

Background: poor physical performance (PP) is known to be associated with disability, lower quality of life and higher mortality rates. Knee and hip osteoarthritis (OA) might be expected to contribute to poor PP, through joint pain and restricted range of movement. Both clinical and self-reported OA are often used for large-scale community and epidemiological studies. Objective: to examine the relationships between hip and knee OA and PP in a large data set comprising cohorts from six European countries. Methods: a total of 2,942 men and women aged 65-85 years from the Germany, Italy, Netherlands, Spain, Sweden and theUK were recruited. Assessment included an interview and clinical assessment for OA. PP was determined from walking speed, chair rises and balance (range 0-12); low PP was defined as a score of =9. Results: the mean (SD) age was 74.2 (5.1) years. Rates of self-reported OA were much higher than clinical OA. Advanced age, female gender, lower educational attainment, abstinence from alcohol and higher body mass index were independently associated with low PP. Clinical knee OA, hip OA or both were associated with a higher risk of low PP; OR (95% CI) 2.93 (2.36, 3.64), 3.79 (2.49, 5.76) and 7.22 (3.63, 14.38), respectively, with relationships robust to adjustment for the confounders above as well as pain. Conclusion: lower limb OA at the hip and knee is associated with low PP, and for clinical diagnosis relationships are robust to adjustment for pain. Those at highest risk have clinical OA at both sites

Relationships between physical performance and knee and hip osteoarthritis: findings from the European Project on Osteoarthritis (EPOSA).

BACKGROUND:poor physical performance (PP) is known to be associated with disability, lower quality of life and higher mortality rates. Knee and hip osteoarthritis (OA) might be expected to contribute to poor PP, through joint pain and restricted range of movement. Both clinical and self-reported OA are often used for large-scale community and epidemiological studies.OBJECTIVE:to examine the relationships between hip and knee OA and PP in a large data set comprising cohorts from six European countries.METHODS:a total of 2,942 men and women aged 65-85 years from the Germany, Italy, Netherlands, Spain, Sweden and the UK were recruited. Assessment included an interview and clinical assessment for OA. PP was determined from walking speed, chair rises and balance (range 0-12); low PP was defined as a score of ≤9.RESULTS:the mean (SD) age was 74.2 (5.1) years. Rates of self-reported OA were much higher than clinical OA. Advanced age, female gender, lower educational attainment, abstinence from alcohol and higher body mass index were independently associated with low PP. Clinical knee OA, hip OA or both were associated with a higher risk of low PP; OR (95% CI) 2.93 (2.36, 3.64), 3.79 (2.49, 5.76) and 7.22 (3.63, 14.38), respectively, with relationships robust to adjustment for the confounders above as well as pain.CONCLUSION:lower limb OA at the hip and knee is associated with low PP, and for clinical diagnosis relationships are robust to adjustment for pain. Those at highest risk have clinical OA at both sites

Relationships between physical performance and knee and hip osteoarthritis: findings from the European Project on Osteoarthritis (EPOSA).

BACKGROUND:poor physical performance (PP) is known to be associated with disability, lower quality of life and higher mortality rates. Knee and hip osteoarthritis (OA) might be expected to contribute to poor PP, through joint pain and restricted range of movement. Both clinical and self-reported OA are often used for large-scale community and epidemiological studies.OBJECTIVE:to examine the relationships between hip and knee OA and PP in a large data set comprising cohorts from six European countries.METHODS:a total of 2,942 men and women aged 65-85 years from the Germany, Italy, Netherlands, Spain, Sweden and the UK were recruited. Assessment included an interview and clinical assessment for OA. PP was determined from walking speed, chair rises and balance (range 0-12); low PP was defined as a score of ≤9.RESULTS:the mean (SD) age was 74.2 (5.1) years. Rates of self-reported OA were much higher than clinical OA. Advanced age, female gender, lower educational attainment, abstinence from alcohol and higher body mass index were independently associated with low PP. Clinical knee OA, hip OA or both were associated with a higher risk of low PP; OR (95% CI) 2.93 (2.36, 3.64), 3.79 (2.49, 5.76) and 7.22 (3.63, 14.38), respectively, with relationships robust to adjustment for the confounders above as well as pain.CONCLUSION:lower limb OA at the hip and knee is associated with low PP, and for clinical diagnosis relationships are robust to adjustment for pain. Those at highest risk have clinical OA at both sites

Association between osteoarthritis and social isolation: data from the EPOSA study

Objective: To determine whether there is an association between osteoarthritis (OA) and incident social isolation using data from the European Project on OSteoArthritis (EPOSA) study.Design: Prospective, observational study with 12 to 18 months of follow-up.Setting: Community dwelling.Participants: Older people living in six European countries.Measurements: Social isolation was assessed using the Lubben Social Network Scale and the Maastricht Social Participation Profile. Clinical OA of the hip, knee, and hand was assessed according to American College of Rheumatology criteria. Demographic characteristics, including age, sex, multijoint pain, and medical comorbidities, were assessed.Results: Of the 1967 individuals with complete baseline and follow-up data, 382 (19%) were socially isolated and 1585 were nonsocially isolated at baseline; of these individuals, 222 (13.9%) experienced social isolation during follow-up. Using logistic regression analyses, after adjustment for age, sex, and country, four factors were significantly associated with incident social isolation: clinical OA, cognitive impairment, depression, and worse walking time. Compared to those without OA at any site or with only hand OA, clinical OA of the hip and/or knee, combined or not with hand OA, led to a 1.47 times increased risk of social isolation (95% confidence interval = 1.03-2.09).Conclusion: Clinical OA, present in one or two sites of the hip and knee, or in two or three sites of the hip, knee, and hand, increased the risk of social isolation, adjusting for cognitive impairment and depression and worse walking times. Clinicians should be aware that individuals with OA may be at greater risk of social isolation

Within-person pain variability and mental health in older adults with osteoarthritis: An analysis across six European Cohorts

Pain is a key symptom of Osteoarthritis (OA) and has been linked to poor mental health. Pain fluctuates over time within individuals, but a paucity of studies have considered day-to-day fluctuations of joint pain in relation to affective symptoms in older persons with OA. This study investigated the relationship of both pain severity and within-person pain variability with anxiety and depression symptoms in 832 older adults with OA who participated in the European Project on OSteoArthritis (EPOSA): a six-country cohort study. Affective symptoms were examined with the Hospital Anxiety and Depression Scale, pain severity was assessed with the WOMAC/AUSCAN, and intra-individual pain variability was measured using pain calendars assessed at baseline, 6 and 12-18 months. Age-stratified multiple linear regression analyses adjusted for relevant confounders showed that more pain was associated with more affective symptoms in older-old participants (74.1-85 years). Moreover, older-old participants experienced fewer symptoms of anxiety (ratio=.85, 95% CI: .77-.94), depression (ratio=.90, 95% CI: .82-.98) and total affective symptoms (ratio=.87, 95% CI: .79-.94) if their pain fluctuated more. No such association was evident in younger-old participants (65-74.0 years). These findings imply that stable pain levels are more detrimental to mental health than fluctuating pain levels in older persons