Siviero, Paolo, Limongi, Federica, Gesmundo, Antonella, Zambon, Sabina, Cooper, Cyrus, Dennison, Elaine, Edwards, Mark, van der Pas, Suzan, Timmermans, Erik J., van Schoor, Natasja M., Schaap, Laura A., Dallmeier, Dhayana, Denkinger, Michael D., Peter, Richard, Castell, Maria Victoria, Otero, Ángel, Pedersen, Nancy L., Deeg, Dorly JH and Maggi, Stefania , (2020) Factors associated with functional decline in hand and hip/knee osteoarthritis after a year’s time: data from the eposa study. Arthritis Care & Research. (doi:10.1002/acr.24404).
Abstract
Objective: the study investigated factors that together with hand or hip/knee osteoarthritis (OA) could contribute to functional decline over a year’s time in elderly individuals.
Methods: the data of 1,886 individuals between the ages of 65‐85 in a prospective, observational population‐based study with 12‐18 month follow‐up in the context of the European Project on OSteoArthritis were analyzed. The outcome measures were self‐reported hand and hip/knee functional decline evaluated using a Minimal Clinically Important Difference of 4 on the AUStralian/CANadian hand OA Index and of 2 on the Western Ontario and McMaster Universities hip/knee OA physical function subscales, both normalized to 0‐100. Using regression models adjusted for sex, age, country, and education level, the baseline factors considered were: clinical hand or hip/knee OA, pain, analgesic/anti‐inflammatory medications, comorbidities, social isolation, income, walking time, grip strength, physical activity time, and medical/social care.
Results: after a year, 453 participants were identified as having “worse” hand functionality and 1,389 as “not worse”. Hand OA, anxiety, walking time and grip strength were risk factors for hand functional decline; pain was a confounder of the effect of hand OA.
Analgesic/anti‐inflammatory medications mediated the combined effect of hip/knee OA+pain on functional decline in the 554 individuals classified as having “worse” hip/knee functionality and the 1,291 “not worse” persons. Peripheral artery disease, obesity, and cognitive impairment were other baseline risk factors.
Conclusion: study findings showed that together with emotional status, chronic physical and cognitive conditions, OA affects hand and hip/knee functional decline.
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