Arthritis and arthritis‐attributable activity limitations in the United States and Canada: A cross‐border comparison

Abstract

Objective. To compare directly the prevalence and risk factors for arthritis and arthritis-attributable activity limitations (AAL) between the US and Canada, and to estimate the population attributable risk percentage (PAR%) for obesity and leisure time physical inactivity. Methods. We conducted analyses of the 2002-2003 Joint Canada/US Health Survey, which asked about health professional-diagnosed arthritis, and arthritis reported as a cause of disability in specified activities of daily living. We used log-Poisson regression to obtain prevalence ratios for arthritis and AAL, adjusting for education, income, having a regular doctor, physical inactivity, and obesity. PAR% for obesity and physical inactivity were calculated. Results. The estimated crude prevalence of arthritis and AAL were 18.7% and 9.3%, respectively, in the US and 16.9% and 7.4%, respectively, in Canada. Being American was a significant bivariate predictor of arthritis and AAL, but not after adjustment for obesity and physical inactivity. PAR% for obesity were 14% and 20% for arthritis and AAL, respectively, for Americans and 13% and 17%, respectively, for Canadians, and for physical inactivity were 15% and 21%, respectively, for Americans and 4% and 5%, respectively, for Canadians, with estimates being higher among women. Conclusion. The higher prevalence of arthritis and AAL in the US may be accounted for by the higher prevalence of obesity and physical inactivity, particularly in women. The high PAR% related to obesity in both countries, and physical inactivity in the US, point to the importance of public health initiatives to reduce obesity and increase physical activity to reduce the prevalence of arthritis and AAL.

Obesity and reduction of the response rate to anti–tumor necrosis factor α in rheumatoid arthritis: An approach to a personalized medicine

“…Second, even more stringent, some studies showed that a BMI of Ͼ30 kg/m 2 was associated with less erosions over time in an early arthritis cohort in Leiden (20), and was associated with a lower prevalence of mortality among RA patients in Texas (21). These data are very difficult to match with other data, showing that, in longstanding RA, obesity determines higher grades of arthritis-attributable physical limitations (22) and is associated with more disease activity and functional disability (6,10,23). In a large community practice database (Quantitative Standardized Monitoring of Patients with Rheumatoid Arthritis) that collected data from 5,161 patients in 25 countries, it was noted that BMI was similar between sexes, but it also transpired that the DAS28 scores among female subjects increased with increasing BMI from normal weight to overweight and obese (24).…”

Public health impact of risk factors for physical inactivity in adults with rheumatoid arthritis

“…21–26 These earlier studies all measured physical activity with self-report instruments as opposed to objective assessment. Inactivity was defined by no reported leisure time activity 25–26 , leisure activities absent of moderate and vigorous intensity or less than 10 minutes/week moderate intensity activities 21 ; less than 3 sessions/month lasting 15 minutes or more of activities associated with moderate intensity energy expenditure 23–24 , and no reported activities lasting 10 minutes or more 22 . In the present study, our definition of physical inactivity is anchored on the federal DHHS definition and is assessed by objective accelerometer monitoring using methods validated in rheumatoid arthritis 27 .…”

Physical exercise as non-pharmacological treatment of chronic pain: Why and when

“…(5) Arthritis is highly prevalent, affecting at least 22% of adults and nearly half of adults older than 65. Furthermore, 43.2% of those with arthritis have an arthritis-attributable activity limitation, (6) and 24-58% of adults with arthritis are physically inactive;(7-13) estimates may be low because they are primarily based on self-report measures.…”