Abstract
BackgroundWe consider the relationships between a clinical and radiological diagnosis of knee or hip OA and activities of daily-living (ADL) in older adults.MethodsData were available for 222 men and 221 women from the Hertfordshire Cohort Study (HCS) who also participated in the UK component of the European Project on Osteoarthritis (EPOSA). Participants completed the EuroQoL survey where they reported if they had difficulties with mobility, self-care, usual activities and movement around their house. Hip and knee radiographs were graded for overall Kellgren and Lawrence score (positive definition defined as a 2 or above). Clinical OA was defined using American College of Rheumatology criteria.ResultsIn men, a clinical diagnosis of hip or knee OA were both associated with reported difficulties in mobility, ability to self-care and performing usual-activities (hip OA: OR 17.6, 95% CI 2.07, 149, p = 0.009; OR 12.5, 95% CI 2.51, 62.3, p = 0.002; OR 4.92, 95% CI 1.06, 22.8, p = 0.042 respectively. Knee OA: OR 8.18, 95% CI 3.32, 20.2, p < 0.001; OR 4.29, 95% CI 1.34, 13.7, p = 0.014; OR 5.32, 95% CI 2.26, 12.5, p < 0.001 respectively). Similar relationships were seen in women, where in addition, a radiological diagnosis of knee OA was associated with difficulties performing usual activities (OR 3.25, 95% CI 1.61, 6.54, p = 0.001). In general, men with OA reported stronger associations between moving around the house, specifically around the kitchen (clinical hip OA: OR 13.7, 95% CI 2.20, 85.6, p = 0.005; clinical knee OA OR 8.45, 95% CI 1.97, 36.2, p = 0.004) than women.Discussion and conclusionClinical OA is strongly related to the ability to undertake ADL in older adults and should be considered in clinic consultations when seeing patients with OA.
Highlights
The increase in life expectancy and the subsequent ageing population has led to a higher prevalence of chronic, noncommunicable diseases and in particular musculoskeletal (MSK) disorders
A clinical diagnosis of hip or of knee OA were both associated with reported difficulties in mobility, ability to self-care and performing usual activities
Very similar relationships were seen in women, where clinical OA at hip and knee were both associated with reported difficulties in mobility, ability to self-care and performing usual activities (Hip OA: OR 5.49, 95% CI 1.63, 18.5, p = 0.006; OR 8.81, 95% CI 2.67, 29.0, p < 0.001 and OR 15.9, 95% CI 3.40, 74.0, p < 0.001 respectively; Knee OA: OR 7.51, 95% CI 3.56, 15.9, p < 0.001; OR 9.52, 95% CI 3.87, 23.4, p < 0.001 and OR 9.20, 95% CI 4.31, 19.7, p < 0.001, respectively)
Summary
The increase in life expectancy and the subsequent ageing population has led to a higher prevalence of chronic, noncommunicable diseases and in particular musculoskeletal (MSK) disorders. There is a breakdown of the equilibrium between breakdown and repair of joint tissue, leading to the loss of articular cartilage, remodelling of subchondral bone, osteophyte formation, ligament laxity, periarticular muscle weakening, and occasionally synovitis [6] This can occur in any joint, but the joints more commonly afflicted by OA are the hands, feet, facet joints and large weight-bearing joints, such as the. Results In men, a clinical diagnosis of hip or knee OA were both associated with reported difficulties in mobility, ability to self-care and performing usual-activities
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