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Knee Osteoarthritis Compromises Early Mobility Function: The Women's Health and Aging Study II
SHARI M. LING, LINDA P. FRIED, ELIZABETH S. GARRETT, MING-YU FAN, TAINA RANTANEN, and JOAN M. BATHON
ABSTRACT.
Methods. Cross sectional analyses were conducted on baseline data of the Women's Health and Aging Study II (WHAS II), an observational study of disability transitions in a cohort of women aged 70-79 upon entry and who were representative of the one-third highest-functioning community-resident women. Standardized questionnaires and examinations were used to assess knee OA features, medication use, pain severity, knee extensor muscle strength, and body weight. Functional limitation was assessed using validated performance measures and self-report measures of task modification and task difficulty. Results. Sixty-nine women classified as "symptomatic" for knee OA, 48 with "asymptomatic/intermittently symptomatic," knee OA, and 285 with "no knee OA" were included in the final analysis. Despite selection for their high level of self-reported function, performance was slower and task modification was more frequently reported among women with knee OA than women without knee OA. Lower knee extensor strength, higher body weight, and greater pain severity were associated with knee OA, and also with functional limitations. Conclusion. Knee OA appeared to be associated with early functional limitations in this cohort of high-functioning, older, community-resident women. Lower knee extensor strength, higher body weight, and pain severity were closely associated with these limitations. The extent to which modification of these factors attenuates knee OA associated functional decline should be investigated. (J Rheumatol 2003;30:114-20) Key Indexing Terms:
KNEE From the Gerontology Research Center, National Institute on Aging; the Division of Geriatric Medicine and Gerontology; the Center on Aging and Health; the Department of Biostatistics, School of Hygiene and Public Health; the Division of Rheumatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA; and the Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland. Supported by National Institute on Aging grant R01 AG1170301A1 and by NIHNCRR, OPDGCRC grant RR00722. Dr. Ling's work on this study was supported in part by the John A. Hartford Foundation. S.M. Ling, MD, Gerontology Research Center, National Institute on Aging, Division of Geriatric Medicine and Gerontology, Center on Aging and Health, Division of Rheumatology; L.P. Fried, MD, Center on Aging and Health; E.S. Garrett, MD; M. Fan, MD, Department of Biostatistics, School of Hygiene and Public Health; J.M. Bathon, MD, Division of Rheumatology, The Johns Hopkins Medical Institutions; T. Rantanen, MD, Department of Health Sciences, University of Jyvaskyla. Address reprint requests to Dr. S.M. Ling, Gerontology Research Center, 5600 Nathan Shock Drive, Box 29, Baltimore, MD 21224. E-mail lingsh@grc.nia.nih.gov Submitted October 21, 2001; revision accepted July 10, 2002. |