Abstract
ObjectivesTo compare the prevalence and incidence of chronic co-morbidities in people with inflammatory rheumatic and musculoskeletal diseases (iRMDs), and to determine whether the prevalent co-morbidities are associated with physical activity levels in people with iRMDs and in those without iRMDs.MethodsParticipants were recruited to the UK Biobank; a population-based cohort. Data were collected about demographics, physical activity, iRMDs (RA, PsA, AS, SLE) and other chronic conditions, including angina, myocardial infarction, stroke, hypertension, pulmonary disease, diabetes and depression. The standardized prevalence of co-morbidities in people with iRMDs was calculated. Cox regression was used to determine the relationship between the presence of an iRMD and an incident co-morbidity. The relationship between the presence (versus absence) of a (co-)morbidity and physical activity level (low, moderate, high) in people with iRMDs and in those without was assessed using multinomial logistic regression.ResultsA total of 488 991 participants were included. The estimated prevalence of each co-morbidity was increased in participants with an iRMD, compared with in those without, particularly for stroke in participants with SLE (standardized morbidity ratio (95% CI), 4.9 (3.6, 6.6). Compared with people with no iRMD and no morbidity, the odds ratios (95% CI) for moderate physical activity were decreased for: no iRMD and morbidity, 0.87 (0.85, 0.89); iRMD and no co-morbidity, 0.71 (0.64, 0.80); and iRMD and co-morbidity, 0.58 (0.54, 0.63).ConclusionHaving a (co-)morbidity is associated with reduced physical activity in the general population, and to a greater extent in participants with an iRMD. Optimal management of both iRMDs and co-morbidities may help to reduce their impact on physical activity.
Highlights
Musculoskeletal diseases, including chronic rheumatic and musculoskeletal diseases (RMDs), are a major global burden, as measured by disability-adjusted life years [1, 2]
To compare the prevalence and incidence of chronic co-morbidities in people with inflammatory rheumatic and musculoskeletal diseases, and to determine whether the prevalent co-morbidities are associated with physical activity levels in people with iRMDs and in those without iRMDs
We considered the proportion of participants with and without an inflammatory RMD who carried out the World Health Organization (WHO)-recommended level of physical activity, which is at least 150 min of moderateintensity physical activity, or at least 75 min of vigorousintensity physical activity per week for adults [29]
Summary
Musculoskeletal diseases, including chronic rheumatic and musculoskeletal diseases (RMDs), are a major global burden, as measured by disability-adjusted life years [1, 2]. The most prevalent inflammatory RMDs are RA, PsA, AS and SLE, with estimated prevalence rates in European adults of 0.8% [3], 0.2% [4], 0.11% [5] and 97 cases per 100 000 population (0.1%) [6], respectively. Patients with these diseases have an increased risk of co-morbid conditions compared with the general population [7, 8], partly explained by the chronic inflammation. Pulmonary disease [12, 13, 1517], diabetes [13, 14] and depression [13, 15] are more common in people with inflammatory RMDs. most studies investigating the prevalence of co-morbidities in people with inflammatory RMDs have been undertaken in disease-specific cohorts, and prevalence estimates of comorbidities vary considerably between studies, partly due to differences in study design, population characteristics and disease ascertainment
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