Tan Guo Jeng, Kioh Sheng Hui, Mat Sumaiyah, Tan Maw Pin, Chan Shirley Huey Ling, Lee Jacintha Mei Ying, Tan Yee Wen
Department of General Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
Department of Chiropractic, Centre Of Complementary and Alternative Medicine, International Medical University, Kuala Lumpur, Malaysia.
Ann Geriatr Med Res. 2023 Dec;27(4):346-352. doi: 10.4235/agmr.23.0011. Epub 2023 Dec 29.
Knee osteoarthritis (OA) is a common cause of physical disability among older adults. While established risk factors for knee OA include age and increased body weight, few studies have examined psychosocial risk factors or progression of knee OA.
The Promoting Independence in our Seniors with Arthritis study recruited participants aged 65 years and over from orthopedic outpatients and community engagement events. Participants were invited to annual visits during which knee OA symptoms were assessed with the Knee Injury and Osteoarthritis Outcome Score (KOOS), social network using the 6-item Lubben Social Network Scale and anxiety and depression using the Hospital Anxiety and Depression scale. Knee OA worsening was defined by a 5% reduction in mean KOOS scores at the last visit compared to the first visit.
Data were available from 148 participants, mean age 66.2±6.5 years and 74.1% female, of whom 28 (18.9%) experienced OA worsening over a median follow-up period of 29 months. Univariate analyses revealed that age, sex, height, grip strength, and social network were associated with OA worsening. Social network remained statistically significantly associated with OA worsening after adjustment for age and sex difference (odds ratio=0.924; 95% confidence interval, 0.857-0.997). The relationship between social network and OA worsening were attenuated by both depression and handgrip strength at baseline.
Psychological status and muscle strength may be modifiable risk factors for social network which may in turn prevent knee OA worsening and should be targeted in future intervention studies.
膝关节骨关节炎（OA）是老年人身体残疾的常见原因。虽然已确定的膝关节OA风险因素包括年龄和体重增加，但很少有研究探讨心理社会风险因素或膝关节OA的进展情况。
“促进关节炎老年人独立”研究从骨科门诊患者和社区参与活动中招募了65岁及以上的参与者。邀请参与者每年进行一次随访，在此期间使用膝关节损伤和骨关节炎结局评分（KOOS）评估膝关节OA症状，使用6项鲁本社会网络量表评估社交网络，使用医院焦虑和抑郁量表评估焦虑和抑郁情况。膝关节OA恶化的定义为与首次随访相比，最后一次随访时平均KOOS评分降低5%。
共有148名参与者的数据可用，平均年龄66.2±6.5岁，女性占74.1%，其中28名（18.9%）在中位随访期29个月内出现OA恶化。单因素分析显示，年龄、性别、身高、握力和社交网络与OA恶化有关。在调整年龄和性别差异后，社交网络与OA恶化仍具有统计学显著相关性（优势比=0.924；95%置信区间，0.857-0.997）。基线时的抑郁和握力均减弱了社交网络与OA恶化之间的关系。
心理状态和肌肉力量可能是社交网络的可改变风险因素，而社交网络反过来可能预防膝关节OA恶化，应在未来的干预研究中作为目标。
