Development of a model for predicting the 4-year risk of symptomatic knee osteoarthritis in China: a longitudinal cohort study

Abstract

Objectives We aimed to develop a model for predicting the 4-year risk of knee osteoarthritis (KOA) based on survey data obtained via a random, nationwide sample of Chinese individuals. Methods Data was analyzed from 8193 middle-aged and older adults included in the China Health and Retirement Longitudinal Study (CHARLS). The incident of symptomatic KOA was defined as participants who were free of symptomatic KOA at baseline (CHARLS2011) and diagnosed with symptomatic KOA at the 4-year follow-up (CHARLS2015). The effects of potential predictors on the incident of KOA were estimated using logistic regression models and the final model was internally validated using the bootstrapping technique. Model performance was assessed based on discrimination—area under the receiver operating characteristic curve (AUC)—and calibration. Results A total of 815 incidents of KOA were identified at the 4-year follow-up, resulting in a cumulative incidence of approximately 9.95%. The final multivariable model included age, sex, waist circumference, residential area, difficulty with activities of daily living (ADLs)/instrumental activities of daily living (IADLs), history of hip fracture, depressive symptoms, number of chronic comorbidities, self-rated health status, and level of moderate physical activity (MPA). The risk model showed good discrimination with AUC = 0.719 (95% confidence interval [CI] 0.700–0.737) and optimism-corrected AUC = 0.712 after bootstrap validation. A satisfactory agreement was observed between the observed and predicted probability of incident symptomatic KOA. And a simple clinical score model was developed for quantifying the risk of KOA. Conclusion Our prediction model may aid the early identification of individuals at the greatest risk of developing KOA within 4 years.

Patterns of change and factors associated with IADL function decline in community-dwelling older adults with arthritis

“…Previous studies have defined disability as an inability to perform ADL or IADL, and found that older adults with chronic conditions and women are at a higher risk of developing a disability 36 , 37 . Older adults living in rural areas have limited access to knowledge regarding the prevention and timely treatment of chronic diseases; a lack of economic resources; and earlier impairments in physical function due to strenuous farm work 38 . It is a well-known that chronic diseases are strongly associated with functional decline.…”

Influencing factors of weak grip strength and fall: a study based on the China Health and Retirement Longitudinal Study (CHARLS)

“…Symptomatic KOA was defined as both doctor-diagnosed arthritis and self-reported pain in the knee joint. The presence of knee joint pain was assessed based on the following question: “Are you often troubled by pain in any part of your body?” and “In what part of your body do you feel pain?” [ 28 ].…”

Depression in Osteoarthritis: Current Understanding

“…They found that patients with mild or moderate to severe depression had a two- or three-times higher risk of developing KOA than those without depression. 30 The risk model showed good discrimination with area under the receiver operating characteristic curve (AUC) = 0.719 (95% CI = 0.700–0.737) and optimism-corrected AUC = 0.712 after bootstrap validation. Similar studies are rare; thus, there is a lack of robust data to support such a hypothesis.…”

“…Recently, Wang et al developed a symptomatic KOA prediction model using secondary analysis of the China Health and Retirement Longitudinal Study data to identify individuals at risk of developing KOA. 30 The authors concluded that previous KOA prediction models had ignored many potential predictors; therefore, this study included depressive symptoms variables in the model. They found that patients with mild or moderate to severe depression had a two- or three-times higher risk of developing KOA than those without depression.…”