Contemporaneous Severity of Symptoms and Functioning Reflected by Variations in Reporting Doctor‐Diagnosed Osteoarthritis

Peeters, Geeske; Parkinson, Lynne; Badley, Elizabeth M.; Jones, Mark; Brown, Wendy J.; Dobson, Annette; Mishra, Gita D.

doi:10.1002/acr.21929

Cited by 7 publications

(6 citation statements)

References 25 publications

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“…Cancer information included in the study has been validated against Cancer Registry data with 89% sensitivity and 97% specificity [ 32 ]. Several other studies have demonstrated the validity of self-reported conditions, BMI, physical activity, and other risk factors [ 19 , 33 – 38 ].…”

Section: Discussionmentioning

confidence: 99%

Progression of diabetes, heart disease, and stroke multimorbidity in middle-aged women: A 20-year cohort study

Mishra

Dobson

et al. 2018

PLoS Med

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BackgroundThe prevalence of diabetes, heart disease, and stroke multimorbidity (co-occurrence of two or three of these conditions) has increased rapidly. Little is known about how the three conditions progress from one to another sequentially through the life course. We aimed to delineate this progression in middle-aged women and to determine the roles of common risk factors in the accumulation of diabetes, heart disease, and stroke multimorbidity.Methods and findingsWe used data from 13,714 women aged 45–50 years without a history of any of the three conditions. They were participants in the Australian Longitudinal Study on Women's Health (ALSWH), enrolled in 1996, and surveyed approximately every 3 years to 2016. We characterized the longitudinal progression of the three conditions and multimorbidity. We estimated the accumulation of multimorbidity over 20 years of follow-up and investigated their association with both baseline and time-varying predictors (sociodemographic factors, lifestyle factors, and other chronic conditions).Over 20 years, 2,511 (18.3%) of the women progressed to at least one condition, of whom 1,420 (56.6%) had diabetes, 1,277 (50.9%) had heart disease, and 308 (12.3%) had stroke; 423 (16.8%) had two or three of these conditions. Over a 3-year period, the age-adjusted odds of two or more conditions was approximately twice that of developing one new condition compared to women who did not develop any new conditions. For example, the odds for developing one new condition between Surveys 7 and 8 were 2.29 (95% confidence interval [CI], 1.93–2.72), whereas the odds for developing two or more conditions was 6.51 (95% CI, 3.95–10.75). The onset of stroke was more strongly associated with the progression to the other conditions (i.e., 23.4% [95% CI, 16.3%–32.2%] of women after first onset of stroke progressed to other conditions, whereas the percentages for diabetes and heart disease were 9.9% [95% CI, 7.9%–12.4%] and 11.4% [95% CI, 9.1%–14.4%], respectively). Being separated, divorced, or widowed; being born outside Australia; having difficulty managing on their available income; being overweight or obese; having hypertension; being physically inactive; being a current smoker; and having prior chronic conditions (i.e., mental disorders, asthma, cancer, osteoporosis, and arthritis) were significantly associated with increased odds of accumulation of diabetes, heart disease, and stroke multimorbidity. The main limitations of this study were the use of self-reported data and the low number of events.ConclusionsStroke was associated with increased risk of progression to diabetes or heart disease. Social inequality, obesity, hypertension, physical inactivity, smoking, or having other chronic conditions were also significantly associated with increased odds of accumulating multimorbidity. Our findings highlight the importance of awareness of the role of diabetes, heart disease, and stroke multimorbidity among middle-aged women for clinicians and health-promotion agencies.

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Section: Discussionmentioning

confidence: 99%

Progression of diabetes, heart disease, and stroke multimorbidity in middle-aged women: A 20-year cohort study

Mishra

Dobson

et al. 2018

PLoS Med

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“…We chose to examine joint symptoms rather than using a formal OA diagnosis, as many women in this age range may not have been diagnosed formally, using, for example, medical imaging. Previous research in this sample showed that fluctuations in joint symptoms coincided with within‐person variation in the self‐report of OA . Two definitions of joint symptoms were used: prevalent joint symptoms (reflecting the presence of symptoms at the end of the followup, irrespective of symptoms perceived during followup), and cumulative incident joint symptoms (reflecting the presence of joint symptoms during followup after the exclusion of those reporting symptoms at the start of the followup).…”

Section: Discussionmentioning

confidence: 99%

“…In each survey, participants were asked to indicate the frequency of experiencing joint pain and stiffness in the last 12 months, with the response options being never, rarely, sometimes, and often. Having joint symptoms was defined as having joint pain and stiffness often at each survey . Two outcome variables were created.…”

Section: Methodsmentioning

confidence: 99%

Potential Effect Modifiers of the Association Between Physical Activity Patterns and Joint Symptoms in Middle‐Aged Women

Peeters

Edwards

Brown

et al. 2018

Arthritis Care & Research

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ObjectiveTo examine whether body mass index (BMI), menopausal status, and hormone therapy (HT) use modify the association between physical activity (PA) patterns throughout middle age and the incidence and prevalence of joint symptoms in women in later middle age.MethodsData were from 6,661 participants (born 1946–1951) in the Australian Longitudinal Study on Women's Health. Surveys, with questions on joint pain and stiffness, PA, height and weight, menopausal symptoms, and HT use, were completed every 3 years from 1998 to 2010. PA patterns were defined as none or low, low or meeting guidelines, fluctuating, or meeting guidelines at all times (reference pattern). Logistic regression was used to examine the association between PA patterns and prevalent (in 2010) and cumulative incident (1998–2010) joint symptoms and effect modification by patterns in BMI, menopausal status, and HT.ResultsThe groups representing fluctuating PA (odds ratio [OR] 1.34 [99% confidence interval (99% CI) 1.04–1.72]) and no or low PA (OR 1.60 [99% CI 1.08–2.35]) had higher odds of incident joint symptoms than those described as meeting guidelines at all times. Stratification by BMI showed that this association was statistically significant in the obese group only. No evidence for effect modification by menopausal status or HT use was found. The findings were similar for prevalent joint symptoms.ConclusionMaintaining at least low levels of PA throughout middle age was associated with a lower prevalence and incidence of joint symptoms later in life. This apparent protective effect of PA on joint symptoms was stronger in obese women than in under‐ or normal‐weight women, and not related to menopause or HT status.

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“…Our definition of first report of OA is as valid and as robust as possible from a community‐based survey. Defining arthritis by self‐report is always problematic; however, our previous research has shown that women were much more likely to report joint symptoms (pain and stiffness) when they reported having OA than when they did not report having OA (odds ratio for within‐person association: 7.3 [95%CI:7.1–7.5]), 25 and we can argue that self‐report OA is a measure of symptomatic OA. Furthermore, a recent systematic review of diagnostic accuracy showed that self‐report has acceptable validity when used in population‐based studies where rheumatologist examination is not feasible 26 .…”

Section: Discussionmentioning

confidence: 95%

Incident osteoarthritis associated with increased allied health services use in ‘baby boomer’ Australian women

Parkinson

Moorin

Peeters

et al. 2016

Australian and New Zealand Journal of Public Health

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Results: The OA group had higher health services use than the Never group. Rate of services use increased over time for both groups. Rate of increase in quarterly doctor attendances was significantly lower for the OA group after onset of OA, with no corresponding change for the Never group. Conclusions:A pre-existing higher use of health services is associated with reporting incident OA, compared to those who never report arthritis. After onset of OA, rate of doctor use reduced and allied health use increased, consistent with recommended Australian treatment guidelines. Implications:This study provides a rare insight into change in healthcare use for people reporting incident OA, against an appropriate comparison group, highlighting the importance of early diagnosis of OA to optimise effective use of health services.Key words: osteoarthritis, arthritis, women, health services, aged O steoarthritis (OA), a degenerative joint disease, characterised by ongoing loss of cartilage and wear on the bony structures of joints, is a common, disabling and progressive chronic disease, which affects more women than men globally.1,2 The Global Burden of Disease project found that OA ranks in the top 20 causes of disability in every region except central sub-Saharan Africa.3 OA is also a costly condition, and was estimated to cost $1.6 billion in direct health expenditure in Australia in 2008-09. 4 The prevalence of OA is increasing due to population ageing. The United Nations estimates that 20% of the global population will be aged over 60 years by 2050. 5 Assuming a conservative estimate that 15% of that 20% will have symptomatic OA, with one-third of these people severely disabled, 6 we can expect that, by 2050, 130 million people will have OA worldwide and 40 million people will be severely disabled by OA. 6,7 There is no cure for OA; consequently, treatment focuses on pain management and maintenance of joint mobility, function and wellbeing. 8 Thus, in an environment of constrained government spending, it is important for policymakers to understand the factors that enable people with OA to remain active and independent in the community with optimal functional capacity. Methods Design and settingA retrospective population-based cohort study was undertaken, using data from participants in Australian Longitudinal Study on Women's Health (ALSWH) with or without incident OA between 2001 and 2010. ALSWH is an Australian national study that began in 1996 with a random sample of more than 40,000 women in three birth cohorts. 16 The ALSWH surveys a range of health, social, psychological and demographic variables. 17Retention rates over the duration of the study have been consistently high; more than 90% for each survey of the 1946-51 cohort. 18Detailed methods for ALSWH are available from www.alswh.org.au. SampleThis study included women from the 1946-51 cohort of the ALSWH who reported a diagnosis of incident OA in 2007 (when aged 56-61 years) and a comparison sample of women in the same cohort who never reported any form of...

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Contemporaneous Severity of Symptoms and Functioning Reflected by Variations in Reporting Doctor‐Diagnosed Osteoarthritis

Cited by 7 publications

References 25 publications

Progression of diabetes, heart disease, and stroke multimorbidity in middle-aged women: A 20-year cohort study

Progression of diabetes, heart disease, and stroke multimorbidity in middle-aged women: A 20-year cohort study

Potential Effect Modifiers of the Association Between Physical Activity Patterns and Joint Symptoms in Middle‐Aged Women

Incident osteoarthritis associated with increased allied health services use in ‘baby boomer’ Australian women

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