Paola Siviero1, Nicola Veronese1, Toby Smith2, Brendon Stubbs3,4, Federica Limongi1, Sabina Zambon5, Elaine M Dennison6, Mark Edwards6, Cyrus Cooper2,6, Erik J Timmermans7, Natasja M van Schoor7, Suzan van der Pas7, Laura A Schaap8, Michael D Denkinger9, Richard Peter10, Florian Herbolsheimer11, Ángel Otero12, Maria Victoria Castell12, Nancy L Pedersen13, Dorly J H Deeg7, Stefania Maggi1. 1. National Research Council, Institute of Neuroscience-Aging Branch, Padova, Italy. 2. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom. 3. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom. 4. Department of Psychological Medicine, King's College, London, United Kingdom. 5. Department of Medicina, University of Padova, Padua, Italy. 6. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom. 7. Department of Epidemiology and Biostatistics, Amsterdam UMC, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands. 8. Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. 9. AGAPLESION Bethesda Hospital, Geriatric Research Unit/Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany. 10. Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany. 11. Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada. 12. Department of Preventive Medicine and Public Health, Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain. 13. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Abstract
OBJECTIVE: To determine whether there is an association between osteoarthritis (OA) and incident social isolation using data from the European Project on OSteoArthritis (EPOSA) study. DESIGN: Prospective, observational study with 12 to 18 months of follow-up. SETTING: Community dwelling. PARTICIPANTS: Older people living in six European countries. MEASUREMENTS: Social isolation was assessed using the Lubben Social Network Scale and the Maastricht Social Participation Profile. Clinical OA of the hip, knee, and hand was assessed according to American College of Rheumatology criteria. Demographic characteristics, including age, sex, multijoint pain, and medical comorbidities, were assessed. RESULTS: Of the 1967 individuals with complete baseline and follow-up data, 382 (19%) were socially isolated and 1585 were nonsocially isolated at baseline; of these individuals, 222 (13.9%) experienced social isolation during follow-up. Using logistic regression analyses, after adjustment for age, sex, and country, four factors were significantly associated with incident social isolation: clinical OA, cognitive impairment, depression, and worse walking time. Compared to those without OA at any site or with only hand OA, clinical OA of the hip and/or knee, combined or not with hand OA, led to a 1.47 times increased risk of social isolation (95% confidence interval = 1.03-2.09). CONCLUSION: Clinical OA, present in one or two sites of the hip and knee, or in two or three sites of the hip, knee, and hand, increased the risk of social isolation, adjusting for cognitive impairment and depression and worse walking times. Clinicians should be aware that individuals with OA may be at greater risk of social isolation. J Am Geriatr Soc 68:87-95, 2019.
OBJECTIVE: To determine whether there is an association between osteoarthritis (OA) and incident social isolation using data from the European Project on OSteoArthritis (EPOSA) study. DESIGN: Prospective, observational study with 12 to 18 months of follow-up. SETTING: Community dwelling. PARTICIPANTS: Older people living in six European countries. MEASUREMENTS: Social isolation was assessed using the Lubben Social Network Scale and the Maastricht Social Participation Profile. Clinical OA of the hip, knee, and hand was assessed according to American College of Rheumatology criteria. Demographic characteristics, including age, sex, multijoint pain, and medical comorbidities, were assessed. RESULTS: Of the 1967 individuals with complete baseline and follow-up data, 382 (19%) were socially isolated and 1585 were nonsocially isolated at baseline; of these individuals, 222 (13.9%) experienced social isolation during follow-up. Using logistic regression analyses, after adjustment for age, sex, and country, four factors were significantly associated with incident social isolation: clinical OA, cognitive impairment, depression, and worse walking time. Compared to those without OA at any site or with only hand OA, clinical OA of the hip and/or knee, combined or not with hand OA, led to a 1.47 times increased risk of social isolation (95% confidence interval = 1.03-2.09). CONCLUSION: Clinical OA, present in one or two sites of the hip and knee, or in two or three sites of the hip, knee, and hand, increased the risk of social isolation, adjusting for cognitive impairment and depression and worse walking times. Clinicians should be aware that individuals with OA may be at greater risk of social isolation. J Am Geriatr Soc 68:87-95, 2019.
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