Abstract

BackgroundKnee osteoarthritis (OA) is a common disease condition associated with aging and a frequent cause of primary care consultations. Few longitudinal studies have been conducted to investigate the incidence of symptomatic knee osteoarthritis (OA) and to identify its risk factors among the Chinese population.MethodsThe China Health and Retirement Longitudinal Study (CHARLS) is a nationwide longitudinal survey of persons aged ≥45 years. Symptomatic knee OA was diagnosed when both self-reported knee pain and self-reported physician-diagnosis arthritis existed. Using the national survey data collected from the CHARLS, we estimated the incidence of symptomatic knee OA, taking into account the complex survey design and response rate. We applied weighted logistic regression analysis to identify its risk factors.ResultsIn the 4-year follow-up, the cumulative incidence of symptomatic knee OA among middle-aged and older Chinese adults was 8.5%; the incidence was higher among females (11.2%) than males (5.6%). Female (odds ratio (OR) 1.98 [95% confidence interval (CI) 1.65–2.37]), rural area (OR 1.32 [95% CI 1.08–1.60]), and West region (OR 2.33 [95% CI 1.89–2.87]) were associated with a higher risk of incident symptomatic knee OA. Physical activities (OR 0.47 [95% CI 0.29–0.76]) and high education level (OR 0.60 [95% CI 0.41–0.88]) was associated with a lower risk of incident symptomatic knee OA, while histories of heart disease (OR 1.40 [95% CI 1.07–1.82]), kidney disease (OR 1.80 [95% CI 1.35–2.39]), and digestive disease (OR 1.54 [95% CI 1.30–1.82]) were associated with a higher risk of incident symptomatic knee OA.ConclusionThe cumulative incidence of symptomatic knee OA over 4 years was relatively high, and varied by province and region. Lack of physical activities was confirmed to be risk factors of incident symptomatic knee OA. The presence of heart disease, kidney disease, and digestive disease may be associated with a higher risk of incident symptomatic knee OA, further research need to confirm these findings.

Highlights

  • Knee osteoarthritis (OA) is a common disease condition associated with aging and a frequent cause of primary care consultations

  • In the China Health and Retirement Longitudinal Study (CHARLS), 15,910 respondents were free from the symptomatic knee OA at the 2011 national baseline survey, among whom 2833 were lost to follow-up in 2013 and 2015

  • Using data collected from the CHARLS, a national population survey with a 4-year follow-up, our study found that the cumulative incidence of symptomatic knee OA over 4 years among Chinese adults aged ≥45 years was 8.5%

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Summary

Introduction

Knee osteoarthritis (OA) is a common disease condition associated with aging and a frequent cause of primary care consultations. Few longitudinal studies have been conducted to investigate the incidence of symptomatic knee osteoarthritis (OA) and to identify its risk factors among the Chinese population. Knee osteoarthritis (OA) is a common disease condition associated with old age and is one of the leading causes of disabilities, which primarily affect elderly adults [3, 4]. A previous study using a nationwide survey found that the prevalence of symptomatic knee OA among Chinese adults aged ≥45 years was 8.1% and increased with age [9], and concluded that future studies are needed to identify the risk factors for incident symptomatic knee OA. The lack of information may hinder the effective planning and execution of health-care strategies, as well as efficient use of health care sources

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