Objective To estimate the lifetime risk of symptomatic knee osteoarthritis (OA), overall and stratified by sex, race, education, history of knee injury, and body mass index (BMI). Methods The lifetime risk of symptomatic OA in at least 1 knee was estimated from logistic regression models with generalized estimating equations among 3,068 participants of the Johnston County Osteoarthritis Project, a longitudinal study of black and white women and men age ≥45 years living in rural North Carolina. Radiographic, sociodemographic, and symptomatic knee data measured at baseline (1990–1997) and first followup (1999–2003) were analyzed. Results The lifetime risk of symptomatic knee OA was 44.7% (95% confidence interval [95% CI] 40.0–49.3%). Cohort members with history of a knee injury had a lifetime risk of 56.8% (95% CI 48.4–65.2%). Lifetime risk rose with increasing BMI, with a risk of 2 in 3 among those who were obese. Conclusion Nearly half of the adults in Johnston County will develop symptomatic knee OA by age 85 years, with lifetime risk highest among obese persons. These current high risks in Johnston County may suggest similar risks in the general US population, especially given the increase in 2 major risk factors for knee OA, aging, and obesity. This underscores the immediate need for greater use of clinical and public health interventions, especially those that address weight loss and self-management, to reduce the impact of having knee OA.

The extent and severity of periodontal attachment loss are described for a random sample of 690 dentate community-dwelling adults, aged 65 or over, residing in five counties in North Carolina. In addition, risk indicators for serious levels of loss of attachment and pocket depth in this population are presented. Pocket depths and recession were measured on all teeth by trained examines during household visits. Blacks had an average of 78% of their sites with attachment loss and the average level of loss in those sites was approximately 4 mm, as compared to 65% and 3.1 min for whites. Because the extent and severity scores in this population were much higher than in younger groups, a serious condition in this group was defined as having 4+ sites of loss of attachment of 5+ mm with one or more of those sites having a pocket of 4+ mm. Bivariate analyses identified a large number of explanatory variables that were associated with increased likelihood of having the more serious periodontal condition. The logistic regression model for blacks includes the following important explanatory variables and associated odds ratios: use to tobacco (2.9), colony counts of B. gingivalis greater than 2% (2.4) and B. intermedius greater than 2% (1.9), last visit to the dentist greater than 3 years (2.3), and gums bleeding in the last 2 weeks (3.9). The model for whites indicated that tobacco use (6.2), presence of B. gingivalis (2.4) and the combined variable of having not been to the dentist in the last 3 years and having a high BANA score (16.8) were important explanatory variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Summary Objective To estimate the lifetime risk of symptomatic hip osteoarthritis (OA). Design We analyzed data from the Johnston County Osteoarthritis Project (a longitudinal population-based study of OA in North Carolina, United States [n=3,068]). The weighted baseline sample comprised 18% blacks and 54% women, and the mean age was 63 years (range=45-93). Symptomatic hip OA was defined as a Kellgren-Lawrence (K-L) radiographic score of ≥2 (anterior-posterior pelvis x-rays) and pain, aching or stiffness on most days, or groin pain, in the same hip. Lifetime risk, defined as the proportion who developed symptomatic hip OA in at least one hip by age 85, among people who live to age 85, was modeled using logistic regression with repeated measures (through generalized estimating equations). Results Lifetime risk of symptomatic hip OA was 25.3% (95% confidence interval [CI] = 21.3–29.3). Lifetime risk was similar by sex, race, highest educational attainment, and hip injury history. We studied lifetime risk by body mass index (BMI) in three forms: at age 18; at baseline and follow-up; and at age 18, baseline and follow-up and found no differences in estimates. Conclusion The burden of symptomatic hip OA is substantial with one in four people developing this condition by age 85. The similar race-specific estimates suggest that racial disparities in total hip replacements are not attributable to differences in disease occurrence. Despite increasing evidence that obesity predicts an increased risk of both hip OA and joint replacement, we found no association between BMI and lifetime risk.

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OBJECTIVE: Our objectives were to examine how certain aspects of provider-patient communication recommended by national asthma guidelines (ie, provider asking for child and caregiver input into the asthma treatment plan) were associated with child asthma medication adherence 1 month after an audio-taped medical visit. METHODS: Children ages 8 through 16 with mild, moderate, or severe persistent asthma and their caregivers were recruited at 5 pediatric practices in nonurban areas of North Carolina. All medical visits were audio-tape recorded. Children were interviewed 1 month after their medical visits, and both children and caregivers reported the child’s control medication adherence. Generalized estimating equations were used to determine if communication during the medical visit was associated with medication adherence 1 month later. RESULTS: Children (n = 259) completed a home visit interview ∼1 month after their audio-taped visit, and 216 of these children were taking an asthma control medication at the time of the home visit. Children reported an average control medication adherence for the past week of 72%, whereas caregivers reported the child’s average control medication adherence for the past week was 85%. Child asthma management self-efficacy was significantly associated with both child- and caregiver-reported control medication adherence. When providers asked for caregiver input into the asthma treatment plan, caregivers reported significantly higher child medication adherence 1 month later. CONCLUSIONS: Providers should ask for caregiver input into their child’s asthma treatment plan because it may lead to better control medication adherence.