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BMC Public Health
Published in: BMC Public Health 1/2006

Open Access 01-12-2006 | Research article

Disabling knee pain – another consequence of obesity: Results from a prospective cohort study

Authors: Clare Jinks, Kelvin Jordan, Peter Croft

Published in: BMC Public Health | Issue 1/2006

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Abstract

Background

Obesity is linked to knee osteoarthritis (OA) and knee pain. These are disabling problems that are more prevalent in older adults. No prospective study has estimated the impact of excess weight avoidance on the occurrence of knee pain in the general older population. The aim of this study was to investigate the influence of overweight and obesity on the onset and progression of knee pain and disability in older adults living in the community.

Methods

A prospective cohort study of people aged 50 and over registered with three general practices in North Staffordshire, UK. 5784 people who had responded to a survey in March 2000 were mailed a follow-up questionnaire in March 2003. The main outcome measures were self-reported knee pain and severe knee pain and disability at 3 years measured by the Western Ontario and McMaster Universities Osteoarthritis index.

Results

Adjusted response to follow-up was 75%. Among responders with no knee pain at baseline, obesity predicted onset of severe knee pain (relative risk 2.8; 95% CI 1.8, 4.5 compared to normal body mass index (BMI) category). Considering overweight and obese categories together, 19% of new cases of severe knee pain over a 3-year period could potentially be avoided by a one-category shift downwards in BMI; this includes almost half of the new cases that arose in the obese group.

Conclusion

Obesity accounts for a substantial proportion of severe disabling knee pain. As knee pain is a common disabling condition in older adults living in the community, effective public health interventions about avoidance of excess weight could have a major impact on future lower limb disability in older adults.
Literature
1.
McTigue KM, Harris R, Hemphill B, Lux L, Sutton S, Bunton A, Lohr K: Screening and interventions for obesity in adults: Summary of the evidence for the U.S. Preventative Services Task Force. Ann Intern Med. 2003, 139 (11): 933-949.CrossRefPubMed
2.
House of Commons Health Committee: Obesity. Third Report of Session 2003–04. 2004, London. Stationery Office Limited, 1:
3.
4.
Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF: Obesity and knee osteoarthritis. The Framingham Study. Ann Intern Med. 1988, 109 (1): 18-24.CrossRefPubMed
5.
Coggon D, Reading I, Croft P, McLaren M, Barrett D, Cooper C: Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord. 2001, 25 (5): 622-7. 10.1038/sj.ijo.0801585.CrossRefPubMed
6.
Jinks C, Jordan K, Croft P: Measuring the population impact of knee pain and disability with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pain. 2002, 100 (1–2): 55-64. 10.1016/S0304-3959(02)00239-7.CrossRefPubMed
7.
Webb R, Brammah T, Lunt M, Urwin M, Allison T, Symmons D: Opportunities for prevention of 'clinically significant' knee pain: results from a population-based cross sectional survey. J Public Health (Oxf). 2004, 26 (3): 277-84. 10.1093/pubmed/fdh162.CrossRef
8.
Gelber AC, Hochberg MC, Mead LA, Wang NY, Wigley FM, Klag MJ: Body mass index in young men and the risk of subsequent knee and hip osteoarthritis. Am J Med. 1999, 107 (6): 542-8. 10.1016/S0002-9343(99)00292-2.CrossRefPubMed
9.
Andersen RE, Crespo CJ, Bartlett SJ, Bathon JM, Fontaine KR: Relationship between body weight gain and significant knee pain in older Americans. Obesity Research. 2003, 11 (10): 1159-1162.CrossRefPubMed
10.
World Health Organization Scientific Group: The Burden of Musculoskeletal Conditions at the Start of the New Millennium. Technical Report Series 919. 2003, Geneva: World Health Organization
11.
Urwin M, Symmons D, Allison T, Brammah T, Bushby H, Roxby M, Simmons A, Williams G: Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis. 1998, 57 (11): 649-655.CrossRefPubMedPubMedCentral
12.
Thomas E, Peat G, Harris L, Wilkie R, Croft PR: The prevalence of pain and pain interference in a general population of older adults: cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP). Pain. 2004, 110: 361-368. 10.1016/j.pain.2004.04.017.CrossRefPubMed
13.
O'Reilly SC, Muir KR, Doherty M: Knee pain and disability in the Nottingham community: association with poor health status and psychological distress. Br J Rheumatol. 1998, 37 (8): 870-873. 10.1093/rheumatology/37.8.870.CrossRefPubMed
14.
Jinks C, Jordan K, Ong BN, Croft P: A brief screening tool for knee pain in primary care (KNEST). 2. Results from a survey in the general population aged 50 and over. Rheumatology. 2004, 43 (1): 55-61. 10.1093/rheumatology/keg438.CrossRefPubMed
15.
Felson DT, Zhang Y, Anthony JM, Naimark A, Anderson JJ: Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study. Ann Intern Med. 1992, 116 (7): 535-9.CrossRefPubMed
16.
Leveille SG, Wee CC, Iezzoni LI: Trends in obesity and arthritis among baby boomers and their predecessors, 1971–2002. Am J Public Health. 2005, 95 (9): 1607-1613. 10.2105/AJPH.2004.060418.CrossRefPubMedPubMedCentral
17.
Jinks C, Lewis M, Ong BN, Croft P: A brief screening tool for knee pain in primary care. I. Validity and reliability. Rheumatology. 2001, 40 (5): 528-536. 10.1093/rheumatology/40.5.528.CrossRefPubMed
18.
Bellamy N: WOMAC Osteoarthritis Index. A Users Guide. London, ON: University of Western Ontario. 1996
19.
World Health Organization: Preventing and Managing the Global Epidemic of Obesity. Report of the World Health Organization Consultation on Obesity. Geneva: World Health Organization. 1997
20.
Shrout P: Measurement reliability and agreement in psychiatry. Statistical Methods in Medical Research. 1998, 7: 301-17. 10.1191/096228098672090967.CrossRefPubMed
21.
Macfarlane GJ, Croft PR, Schollum J, Silman AJ: Widespread pain: is an improved classification possible?. J Rheumatol. 1996, 23 (9): 1628-32.PubMed
22.
Zigmond AS, Snaith RP: The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983, 67 (6): 361-370.CrossRefPubMed
23.
Herrmann C: International experiences with the Hospital Anxiety and Depression Scale – A review of validation data and clinical results. Journal of Psychosomatic Research. 1997, 42 (1): 17-40. 10.1016/S0022-3999(96)00216-4.CrossRefPubMed
24.
Townsend P, Phillimore P, Beattie A: Health and deprivation: inequality and the North. London, Croom Helm. 1988
25.
Thompson ML, Myers JE, Kriebel D: Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done?. Occup Environ Med. 1998, 55: 272-277.CrossRefPubMedPubMedCentral
26.
Greenland S, Rothman KJ: Measures of Effect and Measures of Association. Modern Epidemiology. Edited by: Rothman KJ, Greenland S. 1998, Philadelphia, PA, Lippincott-Raven, 2
27.
Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JW, Dieppe P, Gunther K, Hauselmann H, Herrero-Beaumont G, Kaklamanis P, Lohmander S, Leeb B, Lequesne M, Maziers B, Martin-Mola E, Pavelka K, Pendleton A, Punzi L, Serni U, Swoboda B, Verbruggen C, Zimmerman-Gorska I, Dougados M, Standing Committee for International Clinical Studies Including Therapeutic Trials ESCISIT: Eular Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis. 2003, 62: 1145-55. 10.1136/ard.2003.011742.CrossRefPubMedPubMedCentral
28.
Messier SP, Loeser RF, Miller GD, Morgan TM, Rejeski WJ, Sevick MA, Ettinger WH, Pahor M, Williamson JD: Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum. 2004, 50 (5): 1501-10. 10.1002/art.20256.CrossRefPubMed
29.
Brawley L, Rejeski W, King A: Promoting physical activity for older adults. The challenges of changing behaviour. Am J Prev Med. 2003, 25 (3Sii): 172-83. 10.1016/S0749-3797(03)00182-X.CrossRefPubMed
30.
Roddy E, Zhang W, Doherty M, Arden NK, Barlow J, Birrell F, Carr A, Chakravarty K, Dickson J, Hay E, Hosie G, Hurley M, Jordan KM, McCarthy C, McMurdo M, Mockett S, O'Reilly S, Peat G, Pendleton A, Richards S: Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee- the MOVE consensus. Rheumatology. 2005, 44 (1): 67-73. 10.1093/rheumatology/keh399.CrossRefPubMed
31.
Mehrotra C, Naimi T, Serdula M, Bolen J, Pearson K: Arthritis, Body Mass Index, and professional advice to loose weight. Implications for Clinical Medicine and Public Health. Am Jn Prev Med. 2000, 27 (1): 16-21. 10.1016/j.amepre.2004.03.007.CrossRef
32.
Bowling A, Bond M, Jenkinson C, Lamping DL: Short form 36 (SF36) Health Survey questionnaire: which normative data should be used? Comparisons between the norms provided by the Omnibus Survey in Britain, Health Survey for England and the Oxford Life Survey. Journal of Public Health Medicine. 1999, 21 (3): 255-270.CrossRefPubMed
33.
34.
Kuczmarski M, Kuczmarski RJ, Najjar M: Effects of age on validity of self-reported height, weight, and body mass index: findings from the Third National Health and Nutrition Examination Survey 1988–1994. J Am Diet Ass. 101 (1): 28-34. 10.1016/S0002-8223(01)00008-6.
35.
Department of Health: Health Survey for England. London: The Stationary Office. 1999
36.
Sprangers MA, de Regt EB, Andries F, van Agt HM, Bijl RV, de Boer JB, Foets M, Hoeymans N, Jacobs AE, Kempen GI, Miedema HS, Tijhuis MA, de Haes HC: Which chronic conditions are associated with better or poorer quality of life?. J Clin Epidemiol. 2000, 53 (9): 895-907. 10.1016/S0895-4356(00)00204-3.CrossRefPubMed
Metadata
Title
Disabling knee pain – another consequence of obesity: Results from a prospective cohort study
Authors
Clare Jinks
Kelvin Jordan
Peter Croft
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2006
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-6-258

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