Liu Xiaoting, Huang Yunzhen, Fu Jinjing, Mohedaner Mayila, Yang Gan, Yang Zhenqing, Li Xueqin, Ma Xinye, Zhang Qiqi, Liu Zuyun, Wu Xifeng, Ying Zhimin
Institute of Wenzhou Zhejiang University Wenzhou Zhejiang China.
School of Public Affairs Zhejiang University Hangzhou Zhejiang China.
Aging Med (Milton). 2024 Dec 15;7(6):705-716. doi: 10.1002/agm2.12379. eCollection 2024 Dec.
This study aimed to examine the associations of arthritis with functional disability and depressive symptoms among general US adults. Additionally, it explored the relationship between radiographic knee osteoarthritis (assessed by X-ray examination) and functional disability. Above findings seek to highlight the need for comprehensive physical and mental health management in individuals with arthritis.
We designed a cross-sectional study utilizing multivariable logistic regression models to examine the associations. Odds ratios (OR) and corresponding 95% confidence intervals (CI) were documented in a crude model and three adjusted models. Participants were from the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 1999-2018. Arthritis was self-reported or graded by the Kellgren-Lawrence score after an objective X-ray examination. Functional disability included disability in activities of daily living (ADL disability), instrumental activities of daily living (IADL disability), and mobility disability. Depressive symptom was assessed using the Patient Health Questionnaire (PHQ).
We included 22,566 older adults (≥60 years; 10,961 had self-reported arthritis) for functional disability analysis (2377 older adults with data on X-ray examination; 1012 had radiographic knee osteoarthritis) and 32,056 adults (≥20 years; 9175 had self-reported arthritis) for depressive symptom analysis. After controlling for all covariates, self-reported arthritis was associated with ADL disability (odds ratios [OR]: 2.677; 95% confidence interval [CI]: 2.499-2.868), IADL disability (OR: 2.064; 95% CI: 1.940-2.196), and mobility disability (OR: 2.954; 95% CI: 2.778-3.142), and depressive symptom (OR: 2.177; 95% CI: 1.979-2.395). In participants with data on X-ray examination, radiographic knee osteoarthritis was only associated with mobility disability (OR: 1.437; 95% CI: 1.183-1.744).
Self-reported arthritis was associated with ADL disability, IADL disability and mobility disability, and depressive symptoms. Among participants with X-ray data, radiographic knee osteoarthritis was only associated with mobility disability in general US adults. Appropriate managements of both physical and mental health are needed for individuals with arthritis.
本研究旨在探讨美国普通成年人中关节炎与功能残疾及抑郁症状之间的关联。此外，还探究了影像学膝关节骨关节炎（通过X线检查评估）与功能残疾之间的关系。上述研究结果旨在强调对关节炎患者进行全面身心健康管理的必要性。
我们设计了一项横断面研究，利用多变量逻辑回归模型来检验这些关联。在一个粗模型和三个调整模型中记录了比值比（OR）及相应的95%置信区间（CI）。参与者来自1988 - 1994年和1999 - 2018年的国家健康与营养检查调查（NHANES）。关节炎通过自我报告或在客观X线检查后根据凯尔格伦 - 劳伦斯评分进行分级。功能残疾包括日常生活活动能力残疾（ADL残疾）、工具性日常生活活动能力残疾（IADL残疾）和行动能力残疾。抑郁症状使用患者健康问卷（PHQ）进行评估。
我们纳入了22566名老年人（≥60岁；10961人自我报告患有关节炎）进行功能残疾分析（2377名老年人有X线检查数据；1012人患有影像学膝关节骨关节炎），以及32056名成年人（≥20岁；9175人自我报告患有关节炎）进行抑郁症状分析。在控制所有协变量后，自我报告的关节炎与ADL残疾（比值比[OR]：2.677；95%置信区间[CI]：2.499 - 2.868）、IADL残疾（OR：2.064；95% CI：1.940 - 2.196）、行动能力残疾（OR：2.954；95% CI：2.778 - 3.142）以及抑郁症状（OR：2.177；95% CI：1.979 - 2.395）相关。在有X线检查数据的参与者中，影像学膝关节骨关节炎仅与行动能力残疾相关（OR：1.437；95% CI：1.183 - 1.744）。
自我报告的关节炎与ADL残疾、IADL残疾、行动能力残疾及抑郁症状相关。在有X线数据的参与者中，在美国普通成年人中，影像学膝关节骨关节炎仅与行动能力残疾相关。关节炎患者需要进行适当的身心健康管理。
