Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.

Relationship Between Self-Reported Comorbidity and Health Status in Early OA: The CHECK Study

Wesseling1,  Janet, Bierma-Zeinstra2,  Sita MA, Dekker3,  Joost, Bijlsma4,  Johannes WJ, on behalf of CHECK study group,  

University Medical Center, Utrecht, Netherlands
Erasmus Medical Center, Rotterdam, Netherlands
VU University Medical Center, Amsterdam, Netherlands
University Medical Center, Utrecht


Osteoarthritis (OA) is the most common diagnosis made in older patients with knee or hip pain in primary care. The prevalence of many other disabling conditions rises with age, and some chronic conditions can be found together with OA. An important question is to whether comorbidity and the presence of specific diseases impairs the clinical status of patients with early OA. The objective is to describe the relationship between comorbidity and the health status of participants with early osteoarthritis.


In the Netherlands a prospective 10-year follow-up study was initiated by the Dutch Arthritis Association with participants with early OA related complaints of hip and/or knee: CHECK. Inclusion criteria were pain and/or stiffness of knee and/or hip, age 45– 65 years, and had never or not longer than 6 months ago visited the general practitioner for these symptoms for the first time. The WOMAC was utilized to measure pain, stiffness, and limitations in activities. Physical functioning and mental functioning were measured by SF-36, a generic measure of self-reported health related quality of life (HRQL). The presence of chronic disease was assessed with a standard consensus based list (self- reported health module of Statistics Netherlands), which consists of 24 diseases and disorders. It was investigated if the number of comorbidities influenced outcome and if specific conditions from this score had an effect beyond the comorbidity score.


In CHECK 1002 participants were included, a mean age of 56 years, mean BMI of 26 kg/m2 and 79% female. Over 64% of the included participants had comorbidity: severe disorders of neck, shoulder, elbow, wrist or hand (23%), hypertension (20%) and severe or persistent back disorder (18%) being most prevalent. After controlling for age, gender, and BMI, participants with more comorbidities had more pain (beta 0,5; p <= 0,001), limitation in activities (beta 2,2; p <= 0,001) and a worse health related quality of life (HRQL) (beta -2,2; p <= 0,001). Beyond the score, results (controlling for age, sex, BMI) show that back disorder has the most negative effect on pain and function. Disorders of elbow, shoulder, wrist, or hand have the most negative effects on HRQL (Physical function subscale). On the contrary, participants with hypertension reported less pain and disability when controlling for the number of diseases.


The number of comorbidities deteriorates the health status of participants with complaints of early OA. Next to this, specific disease, like severe back disorder, further increases pain and impairs function. Also disorders of neck, elbow, shoulder, wrist or hand decrease the physical function in HRQL.

To cite this abstract, please use the following information:
Wesseling, Janet, Bierma-Zeinstra, Sita MA, Dekker, Joost, Bijlsma, Johannes WJ, on behalf of CHECK study group, ; Relationship Between Self-Reported Comorbidity and Health Status in Early OA: The CHECK Study [abstract]. Arthritis Rheum 2009;60 Suppl 10 :222
DOI: 10.1002/art.25305

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