Osteoarthritis and frailty in elderly individuals across six European countries: results from the European Project on OSteoArthritis (EPOSA)

Abstract

BackgroundOsteoarthritis (OA) is the most common cause of disability in the elderly. Clinical frailty is associated with high mortality, but few studies have explored the relationship between OA and frailty.The objective of this study was to consider the association between OA and frailty/pre-frailty in an elderly population comprised of six European cohorts participating in the EPOSA project.MethodsLongitudinal study using baseline data and first follow-up waves, from EPOSA; 2,455 individuals aged 65-85 years were recruited from pre-existing population-based cohorts in Germany, Italy, the Netherlands, Spain, Sweden and the United Kingdom. Data were collected on clinical OA at any site (hand, knee or hip), based on the clinical classification criteria developed by the American College of Rheumatology (ACR). Frailty was defined according to Fried's criteria. The covariates considered were age, gender, educational level, obesity and country. We used multinomial logistic regression to analyse the associations between OA, frailty/pre-frailty and other covariates.ResultsThe overall prevalence of clinical OA at any site was 30.4 % (95 % CI:28.6-32.2); frailty was present in 10.2 % (95 % CI:9.0-11.4) and pre-frailty in 51.0 % (95 % CI:49.0-53.0). The odds of frailty was 2.96 (95 % CI:2.11-4.16) and pre-frailty 1.54 (95 % CI:1.24-1.91) as high among OA individuals than those without OA. The association remained when Knee OA, hip OA or hand OA were considered separately, and was stronger in those with increasing number of joints.ConclusionsClinical OA is associated with frailty and pre-frailty in older adults in European countries. This association might be considered when designing appropriate intervention strategies for OA management.

Impact of Osteoarthritis in the Quality of Life of Elderly Patients: Challenge on Professional Healthcare Formation and Practice

“…Having osteoarthritis affecting various parts of the elderly patient's body implies a greater impact on their overall health. This is consistent with other studies (Arthritis Foundation, 2014;Castell et al, 2015;Loeser, 2010) which found that the prevalence of osteoarthritis increases with age, being more common in people over 65 and affecting both men and women.…”

Frailty and reduced physical function go hand in hand in adults with rheumatoid arthritis: a US observational cohort study

“…Pre-frailty was much more prevalent (69%) in this RA cohort than in geriatric cohorts (40-55%) [17,4]. The prevalence of frailty and pre-frailty observed in this RA cohort are greater than those observed in a cohort of elderly patients with osteoarthritis (10% and 51%, respectively) [28] and are comparable to those observed in cohort of patients with chronic obstructive lung disease (COPD) that is on average 10 years older (25% and 51%, respectively) [29]. When frailty status was determined using knee strength, rather than grip strength, the prevalence of frailty decreased to 3%, which is still comparable to that in geriatric cohorts.…”

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

“…A number of drug trials in OA, including ongoing trials, might be relevant to hand OA and have been reviewed elsewhere 202 . The ongoing clinical trials include drugs that inhibit inflammatory mechanisms (such as GM-CSF 203 and anti-IL- 6 204) but novel targets relevant to other OA mechanisms might be needed to move the field forward.…”