Independent associations of socioeconomic factors with disability and pain in adults with knee osteoarthritis Public Deposited

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Creator
  • Renner, Jordan B
    • Affiliation: School of Medicine, Department of Radiology, Thurston Arthritis Research Center
  • Knight, Joshua B
    • Affiliation: School of Medicine
  • Callahan, Leigh
    • Affiliation: School of Medicine, Department of Social Medicine, Thurston Arthritis Research Center, Department of Medicine
  • Luong, My-Linh N
    • Affiliation: Gillings School of Global Public Health, School of Medicine, Thurston Arthritis Research Center, Department of Health Behavior
  • Cleveland, Rebecca J
    • Affiliation: School of Medicine, Thurston Arthritis Research Center
  • Jordan, Joanne
    • Affiliation: School of Medicine, Department of Orthopaedics, Thurston Arthritis Research Center, Department of Medicine
  • Schoster, Britta
    • Affiliation: School of Medicine, Thurston Arthritis Research Center
Abstract
  • Abstract Background The purpose of this study is to explore the relationship between function, pain and stiffness outcomes with individual and community socioeconomic status (SES) measures among individuals with radiographic knee osteoarthritis (rOA). Methods Cross-sectional data from the Johnston County Osteoarthritis Project were analyzed for adults age 45 and older with knee rOA (n = 782) and a subset with both radiographic and symptomatic knee OA (n = 471). Function, pain and stiffness were measured using the Western Ontario and McMasters Universities Index of Osteoarthritis (WOMAC). Individual SES measures included educational attainment (<12 years, ≥12 years) and occupation type (managerial, non-managerial), while community SES was measured using Census block group poverty rate (<12%, 12-25%, ≥25%). SES measures were individually and simultaneously examined in linear regression models adjusting for age, gender, race, body mass index (BMI), occupational physical activity score (PAS), comorbidity count, and presence of hip symptoms. Results In analyses among all individuals with rOA, models which included individual SES measures were observed to show that occupation was significantly associated with WOMAC Function (β =2.91, 95% Confidence Interval (CI) = 0.68-5.14), WOMAC Pain (β =0.93, 95% CI = 0.26-1.59) and WOMAC Total scores (β =4.05, 95% CI = 1.04-7.05), and education was significantly associated with WOMAC Function (β =3.57, 95% CI = 1.25-5.90) and WOMAC Total (β =4.56, 95% CI = 1.41-7.70) scores. In multivariable models including all SES measures simultaneously, most associations were attenuated. However, statistically significant results for education remained between WOMAC Function (β =2.83, 95% CI = 0.38-5.28) and WOMAC Total (β =3.48, 95% CI = 0.18-6.78), as well as for the association between occupation and WOMAC Pain (β =0.78, 95% CI = 0.08-1.48). In rOA subgroup analyses restricted to those with symptoms, we observed a significant increase in WOMAC Pain (β =1.36, 95% CI = 0.07-2.66) among individuals living in a block group with poverty rates greater than 25%, an association that remained when all SES measures were considered simultaneously (β =1.35, 95% CI = 0.06-2.64). Conclusions Lower individual and community SES are both associated with worse function and pain among adults with knee rOA.
Date of publication
Identifier
  • doi:10.1186/1471-2474-14-297
  • 24134116
Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • Rebecca J Cleveland et al.; licensee BioMed Central Ltd.
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Journal title
  • BMC Musculoskeletal Disorders
Journal volume
  • 14
Journal issue
  • 1
Page start
  • 297
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1471-2474
Bibliographic citation
  • BMC Musculoskeletal Disorders. 2013 Oct 17;14(1):297
Access
  • Open Access
Publisher
  • BioMed Central Ltd
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