Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Comorbidity and Health Status in Early Osteoarthritis of Hip and Knee; CHECK Cohort.
Wesseling2, J., Bierma-Zeinstra1, S. M. A., Dekker4, J., Gorter3, K. J., Bijlsma3, J. W. J., on Behalf of the CHECK Group,
Erasmus University Medical Center Rotterdam
Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
University Medical Center Utrecht
VU University Medical Center Amsterdam
Osteoarthritis (OA) is the most common diagnosis made in elderly patients with knee or hip pain. Like OA the prevalence of many other disabling conditions increases with age and many chronic conditions can be found together with OA. The objective of the present study is to describe the relationship between comorbidity (count as well as the presence of specific comorbidities) and complaints (like pain and limitation in activity) and the physical and mental status of participants with complaints of early osteoarthritis.
In the Netherlands a prospective 10-year follow-up study was initiated by the Dutch Arthritis Association in participants with early OA related complaints of hip and/or knee: the CHECK study, to study the onset and progression of OA. Individuals were eligible if they had pain and/or stiffness of knee and/or hip, were aged 4565 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 and limitations in activity. Physical functioning and mental functioning were measured bij SF36. Comorbidity is assessed with a self-reported health module of the Agency of Statistics in the Netherlands with consists of 24 chronic diseases. Linear regression analysis was used to determine the influence of the 'comorbidity count' on the outcome variables pain, and physical and mental functioning.
In CHECK 1002 participants were included, mean age of 56 years, mean BMI of 26 kg/m2 and 79% female. Over 67% of the total study population had comorbidity: disorders of neck, shoulder, elbow, wrist or hand (23%), hypertension (20%) and back disorders (18%) were most prevalent. The results indicate that the pain score and physical function score on the WOMAC deteriorates with about 3 and 4 points respectively with every (extra) comorbidity. The physical and mental status of the SF36 deteriorates with respectively about 2 and 1 point with every (extra) comorbidity. Results of the final model (controlling for age, gender, Kellgren & Lawrence grade) show that severe back disorders have the most negative effect on WOMAC pain, physical functioning and one of the most negative effects on physical status of SF36. The presence of this disorder increases WOMAC pain score on average with 7 points, WOMAC function score with 8 points, and SF36 PCS score with 4 points. The mental status was negatively influenced by the presence of duodenal/gastric, thyroid disease, and migraine or regular headache.
In the early stage of osteoarthritis the effect of the presence of especially diseases in the locomotor system have negative effect on complaints and health status. The clinical implications are that to improve the physical health of participants with early OA of knee and/or hip not only the complaints related to OA have to be treated but also the additional diseases, especially back, neck, shoulder, elbow, wrist or hand disorders or obesity. Apart from the physical status also the mental status is affected in the early stage of OA by the presence of comorbidity and this is a further reason to take comorbidity into account in the management of early OA.
To cite this abstract, please use the following information:
Wesseling, J., Bierma-Zeinstra, S. M. A., Dekker, J., Gorter, K. J., Bijlsma, J. W. J., on Behalf of the CHECK Group, ; Comorbidity and Health Status in Early Osteoarthritis of Hip and Knee; CHECK Cohort. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :184