Impact of Obesity and Knee Osteoarthritis on Morbidity and Mortality in Older Americans

Abstract

Background Obesity and knee osteoarthritis are among the most frequent chronic conditions affecting Americans aged 50 to 84 years. Objective To estimate quality-adjusted life-years lost due to obesity and knee osteoarthritis and health benefits of reducing obesity prevalence to levels observed a decade ago. Design The U.S. Census and obesity data from national data sources were combined with estimated prevalence of symptomatic knee osteoarthritis to assign persons aged 50 to 84 years to 4 subpopulations: nonobese without knee osteoarthritis (reference group), nonobese with knee osteoarthritis, obese without knee osteoarthritis, and obese with knee osteoarthritis. The Osteoarthritis Policy Model, a computer simulation model of knee osteoarthritis and obesity, was used to estimate quality-adjusted life-year losses due to knee osteoarthritis and obesity in comparison with the reference group. Setting United States. Participants U.S. population aged 50 to 84 years. Measurements Quality-adjusted life-years lost owing to knee osteoarthritis and obesity. Results Estimated total losses of per-person quality-adjusted life-years ranged from 1.857 in nonobese persons with knee osteoarthritis to 3.501 for persons affected by both conditions, resulting in a total of 86.0 million quality-adjusted life-years lost due to obesity, knee osteoarthritis, or both. Quality-adjusted life-years lost due to knee osteoarthritis and/or obesity represent 10% to 25% of the remaining quality-adjusted survival of persons aged 50 to 84 years. Hispanic and black women had disproportionately high losses. Model findings suggested that reversing obesity prevalence to levels seen 10 years ago would avert 178 071 cases of coronary heart disease, 889 872 cases of diabetes, and 111 206 total knee replacements. Such a reduction in obesity would increase the quantity of life by 6 318 030 years and improve life expectancy by 7 812 120 quality-adjusted years in U.S. adults aged 50 to 84 years. Limitations Comorbidity incidences were derived from prevalence estimates on the basis of life expectancy of the general population, potentially resulting in conservative underestimates. Calibration analyses were conducted to ensure comparability of model-based projections and data from external sources. Conclusion The number of quality-adjusted life-years lost owing to knee osteoarthritis and obesity seems to be substantial, with black and Hispanic women experiencing disproportionate losses. Reducing mean body mass index to the levels observed a decade ago in this population would yield substantial health benefits. Primary Funding Source The National Institutes of Health and the Arthritis Foundation.

Influencia do indice de massa corporal no equilibrio e na configuracao plantar em obesos adultos

“…Pesquisas referem à influência do IMC no equilíbrio postural estático e dinâmico em indivíduos idosos. A senescência é fator de risco para o aumento da massa corporal, déficit de equilíbrio e declínio da capacidade funcional 15 . Assim, pode ser observado que a idade, a ferramenta utilizada para a avaliação do equilíbrio e o numero de voluntários pode ter influenciado no resultado obtido.…”

Estimating the Burden of Osteoarthritis to Plan for the Future

“…Estimates based on fewer years will likely underestimate OA prevalence. When estimating incidence, some changes are expected due to changes in risk factors and individual behavior, and the effect of institutionalization of older people with OA over time (7)(8)(9)(10). Additionally, there are individuals in the population with OA who may experience symptoms for many years prior to obtaining a diagnosis or seeking care (32).…”

“…The incidence rate expresses the number of new cases occurring during a period of time (typically 1 year) (10). Prevalence indicates the number of cases present in a given population at a particular time (10,11).…”

“…Key OA risk factors include age, sex, obesity, and trauma (6)(7)(8)(9). As the Canadian population is aging and obesity is increasing, OA incidence and prevalence are expected to continue rising (4,5,(7)(8)(9)(10). The Arthritis Alliance of Canada reported that 25% of Canadians and almost 30% of the labor force are expected to have OA by 2040 (11).…”

Osteoarthritis: The Rheumatologist's Perspective

“…Health care practitioners must recognize that OA is associated with increased mortality and reduced healthrelated quality of life [3][4][5]. Losina and colleagues [4] reported earlier this year that obesity and osteoarthritis combine to reduce quality-adjusted life years (QALYs) due to disability and mortality; this finding ranged from 1.86 QALYs lost in nonobese persons with knee OA to 3.5…”