Daniel K White1, Tuhina Neogi2, Uyen-Sa D T Nguyen3, Jingbo Niu2, Yuqing Zhang2. 1. Department of Physical Therapy, University of Delaware, Newark, DE, Department of Physical Therapy and Athletic Training, College of Health and Rehabilitation Sciences, Boston University, dkw@udel.edu. 2. Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston and. 3. Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, MA, USA.
Abstract
OBJECTIVE: To describe trajectories of functional decline over 84 months and study associated risk factors among adults initially without limitation who had or were at risk of knee OA. METHODS: We used annual measures of WOMAC physical function over 84 months from the OA Initiative. We included knees with no functional limitation (i.e. WOMAC = 0) at baseline. Knee-based trajectories of functional decline from WOMAC were identified from a group-based trajectory model (PROC TRAJ). RESULTS: We identified five trajectories from 2110 knees (1055 participants, age 61.0 ± 9.3, BMI 27.1 ± 4.4, 52% women). Half of the knees (54%) remained free of limitation over 84 months, 26% slowly declined to a WOMAC of 1.5, 9% were limitation free for the first 36 months and declined to a WOMAC of 11.3, 6% rapidly declined over the first 12 months and gradually recovered to a WOMAC of 3.3 and 5% steadily declined to a WOMAC of 13.2. Baseline radiographic disease, knee pain, obesity and depressive symptoms at baseline were associated with trajectories of worse functional decline. CONCLUSION: Five per cent of our sample initially without limitation was on a trajectory of progressive functional decline over 84 months later. We found worse disease and health status at baseline to be associated with faster decline over time.
OBJECTIVE: To describe trajectories of functional decline over 84 months and study associated risk factors among adults initially without limitation who had or were at risk of knee OA. METHODS: We used annual measures of WOMAC physical function over 84 months from the OA Initiative. We included knees with no functional limitation (i.e. WOMAC = 0) at baseline. Knee-based trajectories of functional decline from WOMAC were identified from a group-based trajectory model (PROC TRAJ). RESULTS: We identified five trajectories from 2110 knees (1055 participants, age 61.0 ± 9.3, BMI 27.1 ± 4.4, 52% women). Half of the knees (54%) remained free of limitation over 84 months, 26% slowly declined to a WOMAC of 1.5, 9% were limitation free for the first 36 months and declined to a WOMAC of 11.3, 6% rapidly declined over the first 12 months and gradually recovered to a WOMAC of 3.3 and 5% steadily declined to a WOMAC of 13.2. Baseline radiographic disease, knee pain, obesity and depressive symptoms at baseline were associated with trajectories of worse functional decline. CONCLUSION: Five per cent of our sample initially without limitation was on a trajectory of progressive functional decline over 84 months later. We found worse disease and health status at baseline to be associated with faster decline over time.
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