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01.12.2013 | Research article | Ausgabe 1/2013 Open Access

BMC Musculoskeletal Disorders 1/2013

Independent associations of socioeconomic factors with disability and pain in adults with knee osteoarthritis

Zeitschrift:
BMC Musculoskeletal Disorders > Ausgabe 1/2013
Autoren:
Rebecca J Cleveland, My-Linh N Luong, Joshua B Knight, Britta Schoster, Jordan B Renner, Joanne M Jordan, Leigh F Callahan
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2474-14-297) contains supplementary material, which is available to authorized users.

Competing interests

None of the authors have financial or personal relationships to disclose. No funds were provided for writing this manuscript.

Authors’ contributions

RJC participated in analysis and interpretation of data, provided statistical expertise, drafting and critical revision of article. MNL participated in interpretation of data, initial drafting and critical revision of article. JBK participated in drafting and critical revision of article. BS participated in conception and design of study, drafting and critical revision of article, administrative and logistic support. JBR participated in acquisition of data and critical revision of article. JMJ participated in conception and design of study, acquisition of data, interpretation of data and critical revision of article. LFC participated in conception and design of study, analysis and interpretation of data, drafting and critical revision of article, and obtaining of funding. She takes responsibility for the integrity of the work as a whole, from inception to finished article. All authors read and approved the final manuscript.

Abstract

Background

The purpose of this study is to explore the relationship between function, pain and stiffness outcomes with individual and community socioeconomic status (SES) measures among individuals with radiographic knee osteoarthritis (rOA).

Methods

Cross-sectional data from the Johnston County Osteoarthritis Project were analyzed for adults age 45 and older with knee rOA (n = 782) and a subset with both radiographic and symptomatic knee OA (n = 471). Function, pain and stiffness were measured using the Western Ontario and McMasters Universities Index of Osteoarthritis (WOMAC). Individual SES measures included educational attainment (<12 years, ≥12 years) and occupation type (managerial, non-managerial), while community SES was measured using Census block group poverty rate (<12%, 12-25%, ≥25%). SES measures were individually and simultaneously examined in linear regression models adjusting for age, gender, race, body mass index (BMI), occupational physical activity score (PAS), comorbidity count, and presence of hip symptoms.

Results

In analyses among all individuals with rOA, models which included individual SES measures were observed to show that occupation was significantly associated with WOMAC Function (β =2.91, 95% Confidence Interval (CI) = 0.68-5.14), WOMAC Pain (β =0.93, 95% CI = 0.26-1.59) and WOMAC Total scores (β =4.05, 95% CI = 1.04-7.05), and education was significantly associated with WOMAC Function (β =3.57, 95% CI = 1.25-5.90) and WOMAC Total (β =4.56, 95% CI = 1.41-7.70) scores. In multivariable models including all SES measures simultaneously, most associations were attenuated. However, statistically significant results for education remained between WOMAC Function (β =2.83, 95% CI = 0.38-5.28) and WOMAC Total (β =3.48, 95% CI = 0.18-6.78), as well as for the association between occupation and WOMAC Pain (β =0.78, 95% CI = 0.08-1.48). In rOA subgroup analyses restricted to those with symptoms, we observed a significant increase in WOMAC Pain (β =1.36, 95% CI = 0.07-2.66) among individuals living in a block group with poverty rates greater than 25%, an association that remained when all SES measures were considered simultaneously (β =1.35, 95% CI = 0.06-2.64).

Conclusions

Lower individual and community SES are both associated with worse function and pain among adults with knee rOA.

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