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Epidemiology of osteoarthritis: Prevalence, risk factors and functional impact

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Abstract

Osteoarthritis (OA), the most common form of arthritis, is a major contributor to functional impairment and reduced independence in older adults. OA of the hip and knee are two of the most important causes of pain and physical disability in community-dwelling adults. Symptomatic hand OA is a common disease among the elderly, and impairs hand function, this impairment being largely mediated by pain. Like other chronic diseases, the etiology of OA is multifactorial, and several local and systemic risk factors have been identified. Differences in the prevalence of OA may be attributable to both genetic and life-style factors. Disease definition may be based upon clinical or radiographic criteria, although case definition should rely on radiographic features for epidemiological studies. This review focuses on the functional impact of the disease, describes geographic differences in prevalence rates, discusses disease definition criteria, and summarizes the most common risk factors, including age, associated with the risk of OA.

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References

  1. Jordan JM, Kington RS, Lane NE, Nevitt MC, Zhang Y, Sowers MF. Systemic risk factors for osteoarthritis. In Felson DT. Osteoarthritis: new insights. Part 1: The disease and its risk factors. Ann Intern Med 2000; 133: 637–9.

    Google Scholar 

  2. Felson DT, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum 1998; 41: 1343–55.

    Article  PubMed  CAS  Google Scholar 

  3. Yelin E. The economics of osteoarthritis. In Brandt K, Doherty M, Lohmander LS. Eds. Osteoarthritis. New York: Oxford University Press, 1998: 23–30.

    Google Scholar 

  4. Guccione AA, Felson DT, Anderson JJ, et al. The effects of specific medical conditions on functional limitations of elders in the Framingham Study. Am J Public Health 1994; 84: 351–8.

    Article  PubMed  CAS  Google Scholar 

  5. Oliveira SA, Felson DT, Reed JI, Cirillo PA, Walker AM. Increase of symptomatic hand, hip and knee osteoarthritis among patients in a health maintenance organization. Arthritis Rheum 1995; 38: 1134–41.

    Article  Google Scholar 

  6. Van Saase, van Romunde LK, Cats A, Vandenbroucke JP, Valkenbourg HA. Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that of 10 other populations. Ann Rheum Dis 1989; 20: 351–69.

    Google Scholar 

  7. Lawrence RC, Helmick CG, Arnett FC, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum 1998; 42: 778–99.

    Article  Google Scholar 

  8. Guralnik JM, LaCroix AZ, Abbott RD, et al. Maintaining mobility in late life. I. Demographic characteristics and chronic conditions. Am J Epidemiol 1993; 137: 845–57.

    CAS  Google Scholar 

  9. Ettinger WH, Davis MA, Neuhaus JM, Mallon KM. Long-term physical functioning in persons with knee osteoarthritis from NHANES I: effects of comorbid medical conditions. J Clin Epidemiol 1994; 47: 809–15.

    Article  PubMed  CAS  Google Scholar 

  10. Fried LP, Ettinger WH, Hermanson B, Newman AB, Gardin J, for the CHS Collaborative Research Group. Physical disability in older adults: a physiologic approach. J Clin Epidemiol 1994; 47: 747–60.

    Article  PubMed  CAS  Google Scholar 

  11. Zhang Y, Niu J, Kally-Hayes M, Chaisson CE, Aliabadi P, Felson DT. Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly. Am J Epidemiol 2002; 156: 1021–7.

    Article  PubMed  Google Scholar 

  12. Sharma L, Felson D. Studying how osteoarthritis causes disability: nothing is simple. J Rheumatol 1998; 25: 1–4.

    PubMed  CAS  Google Scholar 

  13. Gunther KP, Sturmer T, Sauerland S, et al. Prevalence of generalized osteoarthritis in patients with advanced hip and knee osteoarthritis: the Ulm Osteoarthritis Study. Ann Rheum Dis 1998; 57: 717–23.

    Article  PubMed  CAS  Google Scholar 

  14. Hirsch R, Lethbridge-Cejku M, Scott WW, Reichle R, Plato CC, Tobin J. Association of hand and knee osteoarthritis: evidence for a polyarticular disease subset. Ann Rheum Dis 1996; 55: 25–9.

    Article  PubMed  CAS  Google Scholar 

  15. Kellgren JH, Lawrence JS. Atlas of standard radiographs: the epidemiology of chronic rheumatisms. Oxford: Blackwell Scientific. 1963.

    Google Scholar 

  16. Altman RD, Hochberg M, Murphy WA Jr, Wolfe F, Lequesne M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage 1995; 3(Suppl A): 3–70.

    PubMed  Google Scholar 

  17. Conrozier T, Lequesne M, Favret H, et al. Measurement of the radiological hip joint space width. An evaluation of various methods of measurement. Osteoarthritis Cartilage 2001; 9: 281–6.

    Article  CAS  Google Scholar 

  18. Altman RD, Alarcon G, Appelrough D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum 1990; 33: 1601–10.

    Article  PubMed  CAS  Google Scholar 

  19. Hochberg MC, Lawrence RC, Everett DC, Cornoni Huntley HC. Epidemiologic associations of pain in osteoarthritis of the knee: data from the National Health and Nutrition Examination-I Epidemiologic Follow-up Survey. Semin Arthritis Rheum 1989; 18: 4–9.

    Article  PubMed  CAS  Google Scholar 

  20. Salaffi F, Cavalieri F, Nolli M, Ferraccioli G. Analysis of disability in knee osteoarthritis. Relationship with age, psychological variables, but not with radiographic score. J Rheumatol 1991; 18: 1581–6.

    PubMed  CAS  Google Scholar 

  21. Verbrugge LM. Jette AM. The disablement process. Soc Sci Med 1994; 38: 1–14.

    Article  CAS  Google Scholar 

  22. Jones G, Cooley HM, Bellamy NA. Cross-sectional study of the association between Heberden’s nodes, radiographic osteoarthritis of the hands, grip strength, disability and pain. Osteoarthritis Cartilage 2001; 9: 606–11.

    Article  PubMed  CAS  Google Scholar 

  23. Hart DJ, Doyle DV, Spector TD. Incidence and risk factors for radiographic knee osteoarthritis in middle-aged women: the Chingford Study. Arthritis Rheum 1999; 42: 17–24.

    Article  PubMed  CAS  Google Scholar 

  24. Oliveira SA, Felson DT, Cirillo PA, Reed JI, Walker AM. Body weight, body mass index and incident symptomatic osteoarthritis of the hand, hip and knee. Epidemiology 1999; 10: 161–6.

    Article  Google Scholar 

  25. Felson DT. The Epidemiology of knee osteoarthritis: Results from the Framingham Osteoarthritis Study. Semin Arthritis Rheum 1990; 20(Suppl. 1): 42–50.

    Article  PubMed  CAS  Google Scholar 

  26. Bergstrom G, Bjelle A, Sundh V, et al. Joint disorders at ages 70. 75 and 79 years. Br J Rheumatol 1986; 25: 333–41.

    Article  CAS  Google Scholar 

  27. Lawrence JS, Sebo M. The geography of osteoarthritis. In Nuki G. Ed. The etiopathogenesis of osteoarthrosis. Baltimore: University Park Press, 1980: 155–83.

    Google Scholar 

  28. Hirsch R, Fernandes RJ, Pillemer SR, et al. Hip osteoarthritis prevalence estimates by three radiographic scoring systems. Arthritis Rheum 1998; 41: 361–8.

    Article  PubMed  CAS  Google Scholar 

  29. Hirsch R, Fernandes RJ, Pillemer SR, et al. Enlarged acetabular labra in the Pima Indians. J Rheumatol 1997; 24: 2210–2.

    PubMed  CAS  Google Scholar 

  30. Bagge E, Bielle A, Valkenburg H, Svanborg A. Prevalence of radiographic osteoarthritis in two elderly European populations. Rheumatol Int 1992; 12: 33–8.

    Article  PubMed  CAS  Google Scholar 

  31. Mannoni A, Briganti MP, di Bari M, et al. Prevalence of symptomatic hand osteoarthritis in community-dwelling older persons: the ICARe Dicomano study. Osteoarthritis Cartilage 2000; 8(Suppl A): S11–3.

    PubMed  Google Scholar 

  32. Niu J, Zhang Y, LaValley M, Chaisson CE, Aliabadi P, Felson T. Symmetry and clustering of symptomatic hand osteoarthritis in elderly men and women: the Framingham Study. Rheumatology 2003; 42: 343–8.

    Article  PubMed  CAS  Google Scholar 

  33. Corti MC, Guralnik JM, Sartori L, et al. The impact of cardiovascular and osteoarticular diseases on disability in older Italian men and women: rationale, design and sample characteristics of the PRO.V.A. (Progetto Veneto Anziani) Study. J Am Geriatr Soc 2002; 50: 1535–40.

    Article  PubMed  Google Scholar 

  34. Felson DT, Chaisson CE. Understanding the relationship between body weight and osteoarthritis. Baillières Clin Rheumatol 1997; 11: 671–81.

    Article  PubMed  CAS  Google Scholar 

  35. Gelber AC, Hochberg MC, Mead LA, Wang NY, Wigley FM, Klag MJ. Body mass index in young men and the risk of subsequent knee and hip osteoarthritis. Am J Med 1999; 107: 4–5.

    Article  Google Scholar 

  36. Manek NJ, Hart D, Spector TD, MacGregor AJ. The association of body mass index and osteoarthritis of the knee joint: an examination of genetic and environmental influences. Arthritis Rheum 2003; 48: 1024–9.

    Article  PubMed  Google Scholar 

  37. Gelber AC, Hochberg MC, Mead LA, Wang NY, Wigley FM, Wag MJ. Joint injury in young adults and risk for subsequent knee and hip osteoarthritis. Ann Intern Med 2000; 133: 321–8.

    Article  PubMed  CAS  Google Scholar 

  38. Kivimaki J. Riimaki H. Hanninen K. Knee disorders in carpet and floor layers and painters. Scand J Work Environ Health 1992; 18: 310–6.

    Article  CAS  Google Scholar 

  39. Anderson JJ, Felson DT. Factors associated with osteoarthritis of the knee in the First National Health and Nutrition Examination Survey (NHANES I). Evidence for an association with overweight, race and physical demands of work. Am J Epidemiol 1988: 128: 179–89.

    PubMed  CAS  Google Scholar 

  40. Felson DT, Hannan MT, Naimark A. Occupational physical demands, knee bending, and knee osteoarthritis: results from the Framingham Study. J Rheumatol 1991; 18: 1587–92.

    PubMed  CAS  Google Scholar 

  41. Croft P, Cooper C, Wickham C, Coggon D. Osteoarthritis of the hip and occupational activity. Scand J Work Environ Health 1992; 18: 59–63.

    Article  PubMed  CAS  Google Scholar 

  42. Vingard E, Hogstedt C, Alfredsson L, Fellenius E, Goldie I, Koster M. Coxarthrosis and physical work load. Scand J Work Environ Health 1991; 17: 104–9.

    Article  PubMed  CAS  Google Scholar 

  43. Coggon D, Kellingray S, Inskip H, Croft P, Campbell L, Cooper C. Osteoarthritis of the hip and occupational lifting. Am J Epidemiol 1998; 147: 523–8.

    Article  PubMed  CAS  Google Scholar 

  44. Pope DP, Hunt IM, Birrell FN, Silman AJ, Macfarlane GJ. Hip pain onset in relation to cumulative workplace and leisure time mechanical load: a population based case-control study. Ann Rheum Dis 2003; 62: 322–6.

    Article  PubMed  CAS  Google Scholar 

  45. Cheng Y, Macera CA, Davis DR, Ainsworth BE, Troped PJ, Blair SN. Physical activity and self-reported, physician diagnosed osteoarthritis: is physical activity a risk factor? J Clin Epidemiol 2000; 53: 315–22.

    Article  PubMed  CAS  Google Scholar 

  46. Spector TD, Harris PA, Hart DJ, et al. Risk of osteoarthritis associated with long-term weight-bearing sports: a radiologic survey of the hips and knees in female ex-athletes and population controls. Arthritis Rheum 1996; 39: 988–95.

    Article  PubMed  CAS  Google Scholar 

  47. Spector TD, Nandra D, Hart DJ, et al. Is hormone replacement therapy protective for hand and knee osteoarthritis in women? The Chingford Study. Ann Rheum Dis 1997; 56: 432–4.

    Article  PubMed  CAS  Google Scholar 

  48. Hannan MT, Felson DT, Anderson JJ, et al. Estrogen use and radiographic osteoarthritis of the knee in women: the Framingham Osteoarthritis Study. Arthritis Rheum 1990; 33: 525–32.

    Article  PubMed  CAS  Google Scholar 

  49. Stove J, Sturmer T, Kessler S, Brenner H, Puhl W, Gunther KP. Hysterectomy and patterns of osteoarthritis. The Ulm Osteoarthritis Study. Scand J Rheumatol 2001; 30: 340–5.

    CAS  Google Scholar 

  50. Sowers MF, Lachance L, Jamadar D, et al. The associations of bone mineral density and bone turnover markers with osteoarthritis of the hand and knee in pre- and perimenopausal women. Arthritis Rheum 1999; 42: 483–9.

    Article  PubMed  CAS  Google Scholar 

  51. Felson DT. Nevitt MC. Estrogen and osteoarthritis: how do we explain conflicting results? Prev Med 1999; 28: 445–8.

    CAS  Google Scholar 

  52. Radin EL, Rose RM. Role of subchondral bone in the initiation and progression of cartilage damage. Clin Orthop Rel Res 1986; 213: 34–40.

    Google Scholar 

  53. Hunter DJ, Spector TD. The role of bone metabolism in osteoarthritis. Curr Rheumatol Rep 2003; 5: 15–9.

    Article  PubMed  Google Scholar 

  54. Nevitt MC, Lane NC, Scott JC, et al. Radiographic osteoarthritis of the hip and bone mineral density. The Study of Osteoporotic Fractures Research Group. Arthritis Rheum 1995; 38: 907–16.

    Article  CAS  Google Scholar 

  55. Hunter DJ, Hart D, Snieder H, Bettica P, Swaminathan R, Spector TD. Evidence of altered bone turnover, vitamin D and calcium regulation with knee osteoarthritis in female twins. Rheumatology 2003: 42: 1–6.

    Article  Google Scholar 

  56. Cicuttini FM, Spector TD. What is the evidence that osteoarthritis is genetically determined? Baillières Clin Rheumatol 1997; 11: 657–69.

    Article  PubMed  CAS  Google Scholar 

  57. Spector TD, Cicuttini F, Baker J, Loughlin J, Hart D. Genetic influences on osteoarthritis in women: a twin study. BMJ 1996; 312: 940–3.

    Article  PubMed  CAS  Google Scholar 

  58. Wright GD, Hugkes AE, Regan M, Doherty M. Association of two loci on chromosome 2q with nodal osteoarthritis. Ann Rheum Dis 1996; 55: 317–9.

    Article  PubMed  CAS  Google Scholar 

  59. Gillaspy E, Spreckley K, Wallis G, Doherty M, Spector TD. Investigation of linkage on chromosome 2q and hand and knee osteoarthritis. Arthritis Rheum 2002; 46: 3386–7.

    Article  PubMed  CAS  Google Scholar 

  60. Chapman K, Mustafa Z, Irven C, et al. Osteoarthritis susceptibility locus on chromosome 11q, detected by linkage. Am j Hum Genet 1999; 65: 167–74.

    Article  PubMed  CAS  Google Scholar 

  61. Merlotti D, Santacroce C, Gennari L, et al. HLA antigens and primary osteoarthritis of the hand. J Rheumatol 2003; 30: 1298–304.

    PubMed  CAS  Google Scholar 

  62. Sowers M. Epidemiology of risk factors for osteoarthritis: systemic factors. Curr Opin Rheumatol 2001; 13: 447–51.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Maria Chiara Corti M.C. Corti, MD, MHS.

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Corti, M.C., Rigon, C. Epidemiology of osteoarthritis: Prevalence, risk factors and functional impact. Aging Clin Exp Res 15, 359–363 (2003). https://doi.org/10.1007/BF03327356

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