Longitudinal associations between serum 25-hydroxyvitamin D, physical activity, knee pain and dysfunction and physiological falls risk in community-dwelling older adults

Longitudinal associations of body mass index and abdominal circumference with back pain among community-dwelling adults: data from the Osteoarthritis Initiative

BACKGROUND CONTEXT

Back pain is the most common musculoskeletal problem in both developed and developing countries. The prevalence and burden of back pain increases with age, and the management of back pain becomes increasingly important in the context of global aging. There is increasing evidence that obesity is a modifiable risk factor for musculoskeletal pain in different locations. Understanding the role of obesity in back pain holds great potential for improving understanding of the mechanisms of back pain and for developing new preventive and therapeutic approaches.

PURPOSE

To evaluate the role of weight, body mass index (BMI) and abdominal circumference (AC) in risk of back pain over 96 months.

DESIGN

Prospective cohort study.

PATIENT SAMPLE

The sample was from 4,793 adults in the Osteoarthritis Initiative (OAI) database who had or were at increased risk for knee Osteoarthritis.

OUTCOME MEASURES

Outcome variables included the presence, severity, and frequency of back pain, using the past 30 days as the time frame.

METHODS

Longitudinal analysis of data from 4,793 participants enrolled in the Osteoarthritis Initiative, assessed every 12 or 24 months for weight, BMI (kg/m2), AC (cm), and presence, severity (none, mild, moderate, severe), and frequency (none, rarely, sometimes, often, always) of back pain. BMI and AC were decomposed into between-person and with-person components. Data analyses were performed using mixed-effects logistic (for presence of back pain) or ordered logistic regression (for severity and frequency of back pain) models.

RESULTS

Back pain was reported in 58% of participants at baseline; 70% of those without back pain had incident back pain over 96 months. Both between-person (average value across a participant's all measurements) and within-person (deviations from the participant's average) effects of weight and BMI increased risk of presence, severity, and frequency of back pain (Odds radios (OR) per kg/m2: 1.010-1.046, p<.05) in females but not males, with statistically significant weight*sex and BMI*sex interactions. Similar findings were observed for between-person effects of AC on back pain, and the within-person effect of AC was only associated with back pain severity (OR per cm: 1.009, 95% confidence interval 1.002-1.017, p=.019) in females.

CONCLUSIONS

Greater average weight and BMI and increases in them increased odds of presence, severity, and frequency of back pain over 96 months in middle aged and older women but not men. Only average AC increased odds of back pain over time, in women. These findings suggest that preventing obesity and slowing weight gain is important for the management of back pain.

Association between physical activity and falls among older adults in rural China: are there gender and age related differences?

BACKGROUND

The relationship between physical activity (PA) and falls among older adults is inconsistent, and little is known about the gender-specific association between falls and PA. Moreover, age may modify this relationship. This study aimed to test the association between PA and falls and to investigate the gender and age differences in the association among rural older adults.

METHODS

This cross-sectional data were derived from the baseline survey of Shandong Rural Elderly Health Cohort (SREHC). In total, 3,242 rural older adults aged 60 years and above were included in the analysis. PA was measured by the International Physical Activity Questionnaire Short Form (IPAQ-S). PA levels were classified as low, moderate, elevated and high according to quartiles. Volume of moderate-to-vigorous physical activity (MVPA) was categorized into low, moderate, elevated, and high level based on global recommendations. Information on falls was determined from in-person interviews. Falling was defined to participants as ending up on the floor or ground because they were unable to stop themselves. Logistic regression analysis was employed to explore the association between falls and PA.

RESULTS

Of 3,242 rural older adults, the incidence of falls was 13.1%. In older adults, high levels of PA [odds ratio (OR) = 0.65, 95% confidence interval (CI): 0.47-0.90] or MVPA (OR = 0.68, 95% CI: 0.50-0.94) were related to falls. Moderate (OR = 4.84, 95% CI: 1.68-13.94) or high (OR = 0.54, 95% CI: 0.30-0.99) levels of MVPA were associated with falls in older men. But elevated levels of PA were associated with falls (OR = 0.60, 95% CI: 0.42-0.87) in older women. Among older people younger than 75 years, elevated (OR = 0.54, 95% CI: 0.37-0.79) or high (OR = 0.68, 95% CI: 0.48-0.98) levels of PA were associated with falls.

CONCLUSIONS

Among Chinese rural older adults, PA and MVPA are associated with falls, and there are gender and age differences. To prevent falls, measures need to account for individuals' gender and age to encourage rural older adults to participate more actively in PA. We will conduct longitudinal studies to clarify the causal relationship between PA and fall.

Cigarette smoking and knee osteoarthritis in the elderly: Data from the Korean National Health and Nutritional Examination Survey

BACKGROUND

The relationship between smoking and osteoarthritis (OA) has not been investigated in a large-scale study. The aim of this study was to examine the relationship between smoking and knee OA in the elderly.

METHODS

This study included 5117 subjects aged >60 years who responded to questionnaires on their history of smoking and knee OA diagnosed by a physician taken from the Korean National Health and Nutritional Examination Survey (KNHANES-VI) 2013-2015. We classified all 5117 subjects into 2 groups (the OA group and non-OA group) and compared the demographics and characteristics between the 2 groups. A multivariate logistic regression analysis was conducted to investigate the possible association between knee OA and smoking.

RESULTS

The prevalence of current smoking in the OA group (5.1%) was significantly lower than in the non-OA group (14.6%; p < 0.001). Furthermore, the proportion of moderate smokers who smoked >10 cigarettes per day or heavy smokers who smoked >20 cigarettes per day was significantly higher in the non-OA group. In the multivariate analysis, current smoking history was a preventative factor for the prevalence of OA in a multivariate model that included age, sex, body mass index, waist circumference (OR: 0.752, 95% CI: 0.571-0.989, p = 0.042).

CONCLUSIONS

This large-scale national study highlights an inverse association between smoking and the prevalence of knee OA in the general Korean elder adult population, primarily in males. Further investigation of this relationship between smoking and knee OA is needed to determine smoking's specific mechanism of protection against knee OA.