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Relationships between pain, physical activity and sleep quality among older adults with radiographic knee osteoarthritis: findings from the Hertfordshire Cohort Study

Relationships between pain, physical activity and sleep quality among older adults with radiographic knee osteoarthritis: findings from the Hertfordshire Cohort Study
Relationships between pain, physical activity and sleep quality among older adults with radiographic knee osteoarthritis: findings from the Hertfordshire Cohort Study
Aims: to determine if the relationship between joint pain and sleep quality among individuals with osteoarthritis (OA) differs according to physical activity level among older adults.

Methods: 169 community-dwelling older adults in the UK Hertfordshire Cohort Study (aged 71–80) with radiographic knee OA completed a questionnaire. This included: the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); the Pittsburgh Sleep Quality Index (PSQI); the Longitudinal Aging Study Amsterdam Physical Activity Questionnaire; and the Hospital Anxiety and Depression (HAD) Scale. Logistic regression was used to examine the WOMAC knee pain score in relation to having poor sleep quality (PSQI > 5) with adjustment for sex, age, and anxiety and depression scores; analyses were performed with and without stratification by physical activity category (bottom sex-specific tertile vs. not).

Results: knee pain prevalence (WOMAC pain score > 0) was 40.7% among men and 46.6% among women; 37.0% of men and 50.0% of women reported poor sleep quality (PSQI > 5). Higher WOMAC pain scores were related to increased risk of poor sleep quality; odds ratio (95% CI) per unit increase in pain score: 1.15 (1.01,1.32), p = 0.038). Relationships were similar across physical activity levels.

Conclusions: relationships between joint pain and poor sleep quality among older adults with radiographic knee OA were similar, regardless of physical activity level. Our results highlight the high prevalence of both sleep disturbance and significant knee pain in this group, illustrating the need to consider supportive measures as appropriate in this population.
Knee osteoarthritis, Knee pain, Older adults, Physical activity, Poor sleep quality
1594-0667
Kirkham-Wilson, Fiona
2926698a-6fc2-471d-bf15-8ff6428f893c
Westbury, Leo
5ed45df3-3df7-4bf9-bbad-07b63cd4b281
Bevilacqua, Gregorio
e93e3b18-7d1e-4da5-9fcd-e6b4637e1c2e
Laskou, Faidra
ea7e7a54-092d-4baf-8b18-e0d62c47b878
Fuggle, Nicholas
9ab0c81a-ac67-41c4-8860-23e0fdb1a900
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Kirkham-Wilson, Fiona
2926698a-6fc2-471d-bf15-8ff6428f893c
Westbury, Leo
5ed45df3-3df7-4bf9-bbad-07b63cd4b281
Bevilacqua, Gregorio
e93e3b18-7d1e-4da5-9fcd-e6b4637e1c2e
Laskou, Faidra
ea7e7a54-092d-4baf-8b18-e0d62c47b878
Fuggle, Nicholas
9ab0c81a-ac67-41c4-8860-23e0fdb1a900
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1

Kirkham-Wilson, Fiona, Westbury, Leo, Bevilacqua, Gregorio, Laskou, Faidra, Fuggle, Nicholas and Dennison, Elaine (2025) Relationships between pain, physical activity and sleep quality among older adults with radiographic knee osteoarthritis: findings from the Hertfordshire Cohort Study. Aging Clinical and Experimental Research, 37 (331), [331]. (doi:10.1007/s40520-025-03238-7).

Record type: Article

Abstract

Aims: to determine if the relationship between joint pain and sleep quality among individuals with osteoarthritis (OA) differs according to physical activity level among older adults.

Methods: 169 community-dwelling older adults in the UK Hertfordshire Cohort Study (aged 71–80) with radiographic knee OA completed a questionnaire. This included: the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); the Pittsburgh Sleep Quality Index (PSQI); the Longitudinal Aging Study Amsterdam Physical Activity Questionnaire; and the Hospital Anxiety and Depression (HAD) Scale. Logistic regression was used to examine the WOMAC knee pain score in relation to having poor sleep quality (PSQI > 5) with adjustment for sex, age, and anxiety and depression scores; analyses were performed with and without stratification by physical activity category (bottom sex-specific tertile vs. not).

Results: knee pain prevalence (WOMAC pain score > 0) was 40.7% among men and 46.6% among women; 37.0% of men and 50.0% of women reported poor sleep quality (PSQI > 5). Higher WOMAC pain scores were related to increased risk of poor sleep quality; odds ratio (95% CI) per unit increase in pain score: 1.15 (1.01,1.32), p = 0.038). Relationships were similar across physical activity levels.

Conclusions: relationships between joint pain and poor sleep quality among older adults with radiographic knee OA were similar, regardless of physical activity level. Our results highlight the high prevalence of both sleep disturbance and significant knee pain in this group, illustrating the need to consider supportive measures as appropriate in this population.

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Accepted/In Press date: 9 October 2025
e-pub ahead of print date: 25 November 2025
Keywords: Knee osteoarthritis, Knee pain, Older adults, Physical activity, Poor sleep quality

Identifiers

Local EPrints ID: 507388
URI: http://eprints.soton.ac.uk/id/eprint/507388
ISSN: 1594-0667
PURE UUID: c62252e9-ef83-40b5-acc1-545c5c3e9583
ORCID for Leo Westbury: ORCID iD orcid.org/0009-0008-5853-8096
ORCID for Gregorio Bevilacqua: ORCID iD orcid.org/0000-0001-7819-1482
ORCID for Faidra Laskou: ORCID iD orcid.org/0000-0002-8481-6343
ORCID for Nicholas Fuggle: ORCID iD orcid.org/0000-0001-5463-2255
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961

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Date deposited: 08 Dec 2025 17:47
Last modified: 12 Dec 2025 03:02

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Contributors

Author: Fiona Kirkham-Wilson
Author: Leo Westbury ORCID iD
Author: Gregorio Bevilacqua ORCID iD
Author: Faidra Laskou ORCID iD
Author: Nicholas Fuggle ORCID iD
Author: Elaine Dennison ORCID iD

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