Population‐Based Study of Changes in Arthritis Prevalence and Arthritis Risk Factors Over Time: Generational Differences and the Role of Obesity

Abstract

Objective. To investigate cohort effects in arthritis prevalence across 4 birth cohorts: World War II (born 1935-1944), older and younger baby boomers (born 1945(born -1954(born and 1955(born -1964(born , respectively), and Generation X (born 1965(born -1974, and to determine whether birth cohort effects in arthritis prevalence were associated with differences in risk factors over time or period effects. Methods. Analysis of biannually collected data from the longitudinal Canadian National Population Health Survey, 1994-2011 (n = 8,817 at baseline). Data included self-reported arthritis diagnosed by a health professional, risk factors (years of education, household income, smoking, physical activity, sedentary behavior, body mass index [BMI]), and survey year as an indicator of period. We used hierarchical age-period-cohort analyses to compare the age trajectory of arthritis by birth cohort and to examine the contribution of changes in risk factors and period to cohort differences. Results. More recent cohorts had successively a greater prevalence of arthritis. Risk factors were significantly associated with arthritis prevalence independently of cohort differences. The effects of increasing education and income over time on potentially reducing the arthritis prevalence were almost counter-balanced by effects of increasing BMI. Significant cohort-BMI and age-BMI interactions indicated an earlier age of arthritis onset for obese individuals than those of normal weight. Conclusion. Projections that only take into account the changing age structure of the population may underestimate future trends. Our understanding of the impact of BMI on arthritis is likely an underestimate. Cohort differences focus attention on the need to target arthritis management education to young and middle-aged adults.

Updated Estimates Suggest a Much Higher Prevalence of Arthritis in United States Adults Than Previous Ones

“…Recent reports have suggested a marked increase in total knee replacement utilization, especially in the population 45–64 years of age, that has outpaced the increasing rate of obesity in the same age group . Another study demonstrated higher arthritis prevalence in more recent birth cohorts, compared to previous generations of the same age, partly due to changing patterns of obesity in relatively younger populations . Individuals younger than 65 years of age may perceive arthritis as a condition affecting only the elderly and thus may visit a health professional less often or may ignore occasional joint symptoms.…”

Association between childhood conditions and arthritis among middle-aged and older adults in China: the China Health and Retirement Longitudinal Study

“…Socio-demographic characteristics, health behaviour, obesity and chronic diseases (e.g. hypertension, heart disease and digestive disease) were found to be significant risk factors of arthritis (Blagojevic et al, 2010;Sugiyama et al, 2010;Li et al, 2015;Badley et al, 2017). A study conducted in China suggested that age, gender, physical exercise and cardiovascular disease were associated with arthritis in adulthood and old age (Li et al, 2015).…”

Variation in rehabilitation setting after uncomplicated total knee or hip arthroplasty: a call for evidence-based guidelines

“…In Australia, approximately one in five women and one in seven men will have a TKA [1], and one in eight women and one in ten men will have a THA [2]. The increasing risks are largely attributed to the aging population [1, 3–5], and increasing obesity [1, 4, 6]. In 2017, 91,857 primary TKA and THA procedures were undertaken in Australia; most (TKA 70%; THA 67%) occurred in the private sector [7].…”