Effect of Arthritis in Middle Age on Older-Age Functioning

Department of Medicine, University of California, San Francisco, California, USA.
Journal of the American Geriatrics Society (Impact Factor: 4.57). 02/2008; 56(1):23-8. DOI: 10.1111/j.1532-5415.2007.01511.x
Source: PubMed


To examine whether symptomatic arthritis in middle age predicts the earlier onset of functional difficulties (difficulty with activities of daily living (ADLs) and walking) that are associated with loss of independence in older persons.
Prospective longitudinal study.
The Health and Retirement Study, a nationally representative sample of persons aged 50 to 62 at baseline who were followed for 10 years.
Seven thousand five hundred forty-three subjects with no difficulty in mobility or ADL function at baseline.
Arthritis was measured at baseline according to self-report. The primary outcome was time to persistent difficulty in one of five ADLs or mobility (walking several blocks or up a flight of stairs). Difficulty with ADLs or mobility was assessed according to subject interview every 2 years. Analyses were adjusted for other comorbid conditions, body mass index, exercise, and demographic characteristics.
Twenty-nine percent of subjects reported arthritis at baseline. Subjects with arthritis were more likely to develop persistent difficulty in mobility or ADL function over 10 years of follow-up (34% vs 18%, adjusted hazard ratio (HR)=1.63, 95% confidence interval (CI)=1.43-1.86). When each component of the primary outcome was assessed separately, arthritis was also associated with persistent difficulty in mobility (30% vs 16%, adjusted HR=1.55, 95% CI=1.41-1.71) and persistent difficulty in ADL function (13% vs 5%, adjusted HR=1.85, 95% CI=1.58-2.16).
Middle-aged persons who report a history of arthritis are more likely to develop mobility and ADL difficulties as they enter old age. This finding highlights the need to develop interventions and treatments that take a life-course approach to preventing the disabling effect of arthritis.

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Available from: Thomas Gill, Apr 21, 2015
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    • "These conditions result in decreases in joint range of motion (ROM) and in the ability to generate forces with the hand (Carmeli et al., 2003). These decreases have been shown to lead to limited capacity to perform activities of daily living (Dellhag and Bjelle, 1999) and, consequently, loss of independence (Covinsky et al., 2008). In order to maintain the ability to manipulate objects as functional capability is lost, either the individual needs to adapt and use different strategies, or the object being manipulated must be designed to match the abilities of the person. "
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    • "However, even though quality of life has recently been linked to ambulatory ability in cases with knee osteoarthritis [38] and the negative effect of comorbid diseases and female gender on health related quality of life among knee osteoarthritis cases has been demonstrated [23], studies in this area are similarly sparse in number, and more are strongly indicated. Indeed, given that middle-aged persons with arthritis are at higher risk for developing mobility and activities of daily living difficulties [40], and middle age women with high body mass indices are at increased risk for knee replacement [41], these factors might be especially valuable as focal points for future exploration and intervention. "
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