Dataset Information

Longitudinal impact of joint pain comorbidity on quality of life and activity levels in knee osteoarthritis: data from the Osteoarthritis Initiative.

ABSTRACT:

Objectives

Joint pain comorbidity (JPC) is common in individuals with knee OA. This study investigates the longitudinal association between JPC and health-related quality of life (HRQoL) and physical activity levels in individuals with knee OA.

Methods

Data from the progression cohort of the Osteoarthritis Initiative (n = 1233; age 61 years and 58% females) were analysed. JPC was considered present if individuals reported pain in three or more joint groups, including the knee joints. HRQoL was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) Quality of Life subscale, and self-reported physical activity was determined using the Physical Activity Scale for the Elderly (PASE). Generalized estimating equation (GEE) analyses were performed, adjusted for age, sex, duration of complaints, medical comorbidity, and physical and mental functioning.

Results

Over the 4-year period, 32% of participants never reported JPC, whereas 12% always reported JPC. GEE modelling demonstrated that having JPC was negatively associated with HRQoL [regression coefficient ? (95% CI) -3.57 (-4.69, -2.44)] and not associated with physical activity [-1.32 (-6.61, 3.98)].

Conclusion

Considering the impact of JPC on the HRQoL of individuals with knee OA, the assessment of JPC in individuals with knee OA might be a daily routine.

SUBMITTER: Hoogeboom TJ

PROVIDER: S-EPMC3716330 | biostudies-literature | 2013 Mar

REPOSITORIES: biostudies-literature

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Publications

Longitudinal impact of joint pain comorbidity on quality of life and activity levels in knee osteoarthritis: data from the Osteoarthritis Initiative.

Hoogeboom Thomas J TJ den Broeder Alfons A AA de Bie Rob A RA van den Ende Cornelia H M CH

Rheumatology (Oxford, England) 20121130 3

<h4>Objectives</h4>Joint pain comorbidity (JPC) is common in individuals with knee OA. This study investigates the longitudinal association between JPC and health-related quality of life (HRQoL) and physical activity levels in individuals with knee OA.<h4>Methods</h4>Data from the progression cohort of the Osteoarthritis Initiative (n = 1233; age 61 years and 58% females) were analysed. JPC was considered present if individuals reported pain in three or more joint groups, including the knee join ...[more]

PMID: 23204552

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Project description:BackgroundKnee osteoarthritis (OA) worsens health-related quality of life (HRQoL) but the symptom pathway varies from person to person. We aimed to identify groups of people with knee OA or at its increased risk whose HRQoL changed similarly. Our secondary aim was to evaluate if patient-related characteristics, incidence of knee replacement (KR) and prevalence of pain medication use differed between the identified HRQoL trajectory groups.MethodsEight-year follow-up data of 3053 persons with mild knee OA or at increased risk were obtained from the public Osteoarthritis Initiative (OAI) database. Group-based trajectory modeling was used to identify patterns of experiencing a decrease of ≥10 points (Minimal Important Change, MIC) in the Quality of Life subscale of the Knee injury and Osteoarthritis Outcome Score compared to baseline. Multinomial logistic regression, Cox regression and generalized estimating equation models were used to study secondary aims.ResultsFour HRQoL trajectory groups were identified. Persons in the 'no change' group (62.9%) experienced no worsening in HRQoL. 'Rapidly' (9.5%) and 'slowly' worsening (17.1%) groups displayed an increasing probability of experiencing the MIC in HRQoL. The fourth group (10.4%) had 'improving' HRQoL. Female gender, higher body mass index, smoking, knee pain, and lower income at baseline were associated with belonging to the 'rapidly worsening' group. People in 'rapidly' (hazard ratio (HR) 6.2, 95% confidence interval (CI) 3.6-10.7) and 'slowly' worsening (HR 3.4, 95% CI 2.0-5.9) groups had an increased risk of requiring knee replacement. Pain medication was more rarely used in the 'no change' than in the other groups.ConclusionsHRQoL worsening was associated with several risk factors; surgical and pharmacological interventions were more common in the poorer HRQoL trajectory groups indicating that HRQoL does reflect the need for OA treatment. These findings may have implications for targeting interventions to specific knee OA patient groups.

Project description:IntroductionBone marrow lesion (BML) size may be an important imaging biomarker for osteoarthritis-related clinical trials and reducing BML size may be an important therapeutic goal. However, data on the interrelationships between BML size, pain, and structural progression are inconsistent and rarely examined in the same cohort. Therefore, we evaluated the cross-sectional and longitudinal associations of BML volume with knee pain and joint space narrowing (JSN).MethodsA BML volume assessment was performed on magnetic resonance images of the knee collected at the 24- and 48-month Osteoarthritis Initiative visits from a convenience sample of 404 participants in the progression cohort. During the same visits, knee pain was assessed with WOMAC pain scores and knee radiographs were acquired and scored for JSN. BML volume was summed to generate a total knee volume and an index tibiofemoral compartment volume (compartment with greater baseline JSN). Primary analyses included multiple linear regressions (outcome = pain, predictor = total knee BML volume) and logistic regressions (outcome = JSN, predictor = index tibiofemoral compartment BML volume).ResultsThis sample was 49% female with a mean age of 63 (9.2 standard deviation (SD)) years, and 71% had radiographic osteoarthritis in the study knee. Larger baseline BMLs were associated with greater baseline knee pain (P = 0.01), the presence of JSN at baseline (odds ratio (OR) = 1.50, 95% confidence interval (CI) = 1.23 to 1.83), and JSN progression (OR = 1.27, 95%CI = 1.11 to 1.46). Changes in total knee BML volume had a positive association with changes in knee pain severity (P = 0.004) and this association may be driven by knees that were progressing from no or small baseline BMLs to larger BMLs. In contrast, we found no linear positive relationship between BML volume change and JSN progression. Instead, regression of medial tibiofemoral BML volume was associated with JSN progression compared to knees with no or minimal changes in BML volume (OR = 3.36, 95%CI = 1.55 to 7.28). However, follow-up analyses indicated that the association between JSN progression and BML volume change may primarily be influenced by baseline BML volume.ConclusionLarge baseline BMLs are associated with greater baseline knee pain, the presence of JSN at baseline, and disease progression. Additionally, BML regression is associated with decreased knee pain but not a reduced risk of concurrent JSN progression.

Dataset Information

Longitudinal impact of joint pain comorbidity on quality of life and activity levels in knee osteoarthritis: data from the Osteoarthritis Initiative.

Objectives

Methods

Results

Conclusion

Publications

Longitudinal impact of joint pain comorbidity on quality of life and activity levels in knee osteoarthritis: data from the Osteoarthritis Initiative.

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