Association of a healthy lifestyle with mortality risk among individuals with osteoarthritis: a prospective cohort study of the UK Biobank.

BACKGROUND

Osteoarthritis is common and often coexists with other chronic conditions, which may contribute to increased all-cause mortality. Maintaining a healthy lifestyle contributes to increased longevity; however, considering physical functions and physiological conditions of patients with osteoarthritis differ from the general population, the impact of maintaining a healthy lifestyle in these patients remains uncertain, which poses a challenge to implementing-related interventions in this population. This study aims to examine the association between healthy lifestyle factors and mortality in individuals with osteoarthritis.

METHODS

This cohort study enrolled 52 973 participants from the UK Biobank who met the criteria for osteoarthritis as defined via hospitalisation or primary care records. Seven lifestyle factors, consisting of smoking, alcohol intake, physical activity, diet, television watching time, sleep duration and social connection, were included. HRs (with 95% CIs) for total and cause-specific mortality were estimated by Cox proportional hazards regression models.

RESULTS

A total of 4637 deaths were recorded during the follow-up period. Seven healthy lifestyle factors were all independently associated with a low mortality risk. When compared with participants meeting only 0-2 healthy lifestyle criteria, the adjusted HRs (95% CI) for those adhering to 3-7 factors were 0.70 (0.62 to 0.78), 0.60 (0.54 to 0.67), 0.49 (0.44 to 0.54), 0.46 (0.41 to 0.52) and 0.42 (0.36 to 0.49), respectively ( for trend <0.001). A dose-response pattern was also observed for mortality from cancer, cardiovascular, respiratory and digestive diseases (all for trend <0.001), whereas no significant trend emerged for mortality due to neurodegenerative diseases.

CONCLUSIONS

Adherence to a greater number of healthy lifestyle factors was associated with a significantly lower risk of mortality among individuals with osteoarthritis. Our findings hold important public health implications and provide empirical evidence that adhering to a healthy lifestyle could mitigate the burdens caused by osteoarthritis.