Predictors of resilience in older adults with lower limb osteoarthritis and persistent severe pain

Abstract

Background Resilience refers to the process in which people function well despite adversity. Persistent severe pain may be considered an adversity in people with lower limb osteoarthritis (LLOA). The objectives of this study are: (1) to identify what proportion of older adults with LLOA and persistent severe pain show good functioning; and (2) to explore predictors of resilience. Methods Data from the European Project on OSteoArthritis (EPOSA) were used involving standardized data from six European population-based cohort studies. LLOA is defined as clinical knee and/or hip osteoarthritis. Persistent severe pain is defined as the highest tertile of the pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index both at baseline and follow-up. Resilience is defined as good physical, mental or social functioning at follow-up despite having LLOA with persistent severe pain. Results In total, 95 (14.9%) out of 638 individuals with LLOA had persistent severe pain. Among these, 10 (11.0%), 54 (57.4%) and 49 (53.8%) had good physical, mental and social functioning, respectively. Only 4 individuals (4.5%) were resilient in all three domains of functioning. Younger age, male sex, higher education, higher mastery, smoking and alcohol use, higher physical activity levels, absence of chronic diseases, and more contacts with friends predicted resilience in one or more domains of functioning. Conclusions Few people with LLOA and persistent severe pain showed good physical functioning and about half showed good mental or social functioning. Predictors of resilience differed between domains, and might provide new insights for treatment.

The relationship between experience of knee pain and physical activity participation: A scoping review of quantitative studies

“…All nine studies were published between March 2007 and March 2022 [ 30 , 43 , [45] , [46] , [47] , [48] , [49] , [50] , [51] ]. Five studies took place in community settings [ 45 , [47] , [48] , [49] , 51 ], two in clinic settings including general practice and rheumatology clinics [ 30 , 50 ], one in both community and clinic settings [ 46 ] and one in both the community and a health care centre [ 43 ]. All studies were carried out in high-income countries.…”

“…All studies were carried out in high-income countries. Six studies were conducted in the United States [ 43 , 45 , [47] , [48] , [49] , [50] ], one each in Japan, the Netherlands and Germany [ 30 , 46 , 51 ], and one in six European countries [ 51 ]. Of the articles, seven consisted of secondary data analysis [ 30 , 43 , 45 , 47 , 48 , 50 , 51 ] and the other two were primary studies [ 46 , 49 ].…”

“…Six studies were conducted in the United States [ 43 , 45 , [47] , [48] , [49] , [50] ], one each in Japan, the Netherlands and Germany [ 30 , 46 , 51 ], and one in six European countries [ 51 ]. Of the articles, seven consisted of secondary data analysis [ 30 , 43 , 45 , 47 , 48 , 50 , 51 ] and the other two were primary studies [ 46 , 49 ]. All studies used a cross-sectional study design [ 30 , 43 , [45] , [46] , [47] , [48] , [49] , [50] ], with the exception of one which was a prospective cohort study [ 51 ].…”

Osteoarthritis Literacy and Equity Issues: A Post COVID-19 Analysis and Update

“…In addition, those osteoarthritis sufferers who fall into the higher age ranges and who are already a group likely to be more intently affected by health illiteracy in general may be especially negatively impacted if they are poorly informed about their role in fostering their well being and avoiding health risks. The quality of available education programs when currently reviewed, even if accessible, also appears to have multiple shortcomings that may well deter those with limited literacy in adverse, rather than favorable ways [16][17][18][19][20].…”

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“…58,62 In addition the role of face to face personalized health coaching and efforts to boost physical resilience directly may help to effectively counter the extent of any ensuing disability quite markedly and significantly at lower costs than would occur by failing to do this. [59][60][61] However, much more carefully designed clinical research is clearly needed if we are to uncover the degree to which older adults living alone who have varying degrees of osteoarthritis may yet be at risk for acquiring COVID-19 or developing severe COVID symptoms, as well as long COVID and how to ensure COVID-19 protection in these older adults through careful self-management approaches and conservative interventions that can be applied without direct assistance. Policy makers can help to ensure resource accessibility and should be regularly apprised of the true benefits and multiple advantages of one or more of the aforementioned actions that are urgently needed to avert a tsunami of health care costs as well as social costs.…”