Predicting poor functional outcome in community-dwelling older adults with knee pain: prognostic value of generic indicators

Mallen, Christian; Peat, George; Thomas, Elaine; Lacey, Rosie J.; Croft, Peter

doi:10.1136/ard.2006.067975

Cited by 71 publications

(85 citation statements)

References 35 publications

(34 reference statements)

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“…This is the first study that is primarily aimed at examining the interrelations between BMI, depressed mood, knee pain and activity limitations in knee OA. Five earlier studies examined these interrelations in the context of a larger study on determinants of pain and activity limitations [9,12,[17][18][19]. The results of two of these five studies were in agreement with our results [12,17].…”

Section: Discussionsupporting

confidence: 82%

“…The results of two of these five studies were in agreement with our results [12,17]. Three studies did not find independent associations between BMI, depressed mood, and pain and activity limitations [9,18,19]. However, the latter studies found that BMI and helplessness [18] or anxiety [9] (psychological concepts closely related to depressed mood) were independently associated with pain or activity limitations.…”

Section: Discussionsupporting

confidence: 81%

“…On the other hand, three other studies did not find independent associations between BMI, depressed mood, pain and activity limitations [9,18,19]. The five studies described above were not primarily aimed at examining the interrelations between BMI, depressed mood, pain and activity limitations.…”

Section: Introductionmentioning

confidence: 99%

“…Overweight and depressed mood are more common in knee osteoarthritis (OA) than in the general population [1][2][3], and are both positively associated with pain and activity limitations [4][5][6][7][8][9][10][11][12][13]. There is growing evidence that overweight, as indicated by body-mass index (BMI) ≥ 25 kg/m 2 , and depressed mood are interrelated [14,15], and that common biological and psychological mechanisms underlie the development of both overweight and depressed mood [16].…”

Section: Introductionmentioning

confidence: 99%

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Depression and Perceived Quality of Sleep in Older Adults with Knee Osteoarthritis

Park¹,

Kim²

2017

J Korean Gerontol Nurs

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Background: Body-mass index (BMI) and depressed mood are both positively associated with pain and activity limitations in knee osteoarthritis (OA), and are interrelated. The aims of the present study were: 1) to assess whether BMI and depressed mood are independently associated with knee pain and activity limitations; and 2) to compare the relative contributions of BMI and depressed mood to knee pain and activity limitations. Methods: A cross-sectional study in 294 patients with clinical knee OA. Regression analyses were performed with knee pain or activity limitations (self-reported and performance-based) as dependent variables, and BMI and depressed mood as independent variables. All analyses were adjusted for age, gender, marital status, education level, radiographic OA and comorbidity. Dominance analyses were performed to examine the relative contributions of BMI and depressed mood to knee pain and activity limitations. Results: BMI and depressed mood were positively and independently associated with knee pain and activity limitations. BMI and depressed mood explained small parts (3.0% and 2.3%, respectively) of variance in knee pain. BMI explained a substantial part of variance in both self-reported (9.8%) and performance-based (20.4%) activity limitations, while depressed mood explained a small part of variance (3.1% in self-reported and 2.6% in performance-based activity limitations). Conclusions: In patients with knee OA both BMI and depressed mood seem to be independently associated with knee pain and activity limitations. The contribution of BMI to activity limitations is most substantial, thereby offering a relevant target for interventions.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Depression and Perceived Quality of Sleep in Older Adults with Knee Osteoarthritis

Park¹,

Kim²

2017

J Korean Gerontol Nurs

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“…Associations between activity limitations in knee and/or hip OA and ethnicity (11,34,35), multiplesite joint pain (36,37), morning stiffness (38), comorbidity count (5,39), BMI (8), impaired hip flexion (33), bodily pain (8), general health perception (6), and the pain coping strategy transformation (40) have been identified previously in established OA. Furthermore, the results of the present study confirm earlier observations that radiographic status is not closely associated with physical function in patients with knee or hip OA (41)(42)(43).…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for the two‐year course of activity limitations in early osteoarthritis of the hip and/or knee

Holla¹,

Steultjens²,

Roorda³

et al. 2010

Arthritis Care & Research

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Objective. To predict the 2-year course of activity limitations in patients with early knee and/or hip osteoarthritis (OA). Methods. The Cohort Hip & Cohort Knee (CHECK) study is a prospective followup study. The CHECK cohort, comprising participants (n ‫؍‬ 1,002) with early OA-related knee and/or hip symptoms, was followed for 2 years. Participants completed questionnaires and underwent physical, laboratory, and radiographic examination. Regression models were used to examine whether baseline variables predicted the course of activity limitations as measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Analyses were performed separately for participants with knee symptoms and participants with hip symptoms. Results. After 2 years of followup, activity limitations slightly decreased. Large between-subject variation was observed in WOMAC change scores. In participants with knee symptoms, young age, non-Western ethnicity, bilateral hip pain, morning stiffness in the knee, high comorbidity count, high body mass index, high bodily pain, poor general health perception, and pain coping strategy were associated with a poor 2-year outcome on activity limitations. In participants with hip symptoms, few activity limitations at baseline, bilateral hip pain, morning stiffness in the knee, high comorbidity count, low active hip flexion, poor general health perception, and pain coping strategy were associated with a poor 2-year outcome on activity limitations. Conclusion. After 2 years of followup, large between-subject variation was observed in the course of activity limitations. The course of activity limitations is to some extent already predictable at an early stage of knee and hip OA.

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Point-of-Care Prognosis for Common Musculoskeletal Pain in Older Adults

Mallen¹,

Thomas²,

Belcher³

et al. 2013

JAMA Intern Med

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Importance: Many site-specific, multivariable risk models for predicting the outcome of musculoskeletal pain problems have been published. The overlapping content in these models suggests a common set of generic indicators suitable for use in primary care. Objective: To investigate whether a brief set of generic prognostic indicators can predict the outcome of musculoskeletal pain in older patients presenting to general practitioners. Design, Setting, and Participants: A prospective observational cohort study conducted from September 1, 2006, through March 31, 2007, of consecutive patients 50 years or older presenting with noninflammatory musculoskeletal pain to 1 of the 5 participating general practices in the United Kingdom. Main Outcome Measures: During consultation, the treating physician assessed and recorded 5 brief generic items (duration of present pain episode, current pain intensity, pain interference with daily activities, presence of multiple-site pain, and ultrashort depression screen) and recorded their overall prognostic judgment. The primary outcome was patient-rated improvement, which was measured 6 months after consultation and crossvalidated with repeated measures up to 3 years. Results: A total of 194 (48.1%) of 403 participants were classified as having an unfavorable outcome at 6 months. Inclusion of 3 generic prognostic indicators (duration of present pain episode, pain interference with daily activities, and presence of multiple-site pain) in the prognostic model improved on reliance on physicians' prognostic judgment alone (C statistic = 0.72 vs 0.62; net reclassification index=0.136; proportion correctly clas-sified=69%). The improvement in prognostic accuracy was attributable to correcting physicians' tendency toward overoptimistic expectations of outcome. Conclusions and Relevance: Three easy-to-obtain pieces of information followed by systematic recording of the general practitioners' prognostic judgment provide a simple generic assessment of prognosis at point of care in older persons presenting with musculoskeletal problems to primary care practices in the United Kingdom. Such an assessment offers a common foundation for investigating the usefulness of prognostic stratification for guiding management in the consultation across a range of common painful conditions.

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Predicting poor functional outcome in community-dwelling older adults with knee pain: prognostic value of generic indicators

Cited by 71 publications

References 35 publications

Depression and Perceived Quality of Sleep in Older Adults with Knee Osteoarthritis

Depression and Perceived Quality of Sleep in Older Adults with Knee Osteoarthritis

Prognostic factors for the two‐year course of activity limitations in early osteoarthritis of the hip and/or knee

Point-of-Care Prognosis for Common Musculoskeletal Pain in Older Adults

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