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van Schoor NM, Zambon S, Castell MV, Cooper C, Denkinger M, Dennison EM, Edwards MH, Herbolsheimer F, Maggi S, Sánchez-Martinez M, Pedersen NL, Peter R, Schaap LA, Rijnhart JJM, van der Pas S, Deeg DJH. Impact of clinical osteoarthritis of the hip, knee and hand on self-rated health in six European countries: the European Project on OSteoArthritis. Qual Life Res 2016; 25:1423-32. [PMID: 26547441 PMCID: PMC4870285 DOI: 10.1007/s11136-015-1171-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2015] [Indexed: 12/25/2022]
Abstract
PURPOSE Osteoarthritis (OA) has been shown to be associated with decreased physical function, which may impact upon a person's self-rated health (SRH). Only a few studies have examined the association between OA and SRH in the general population, but to date none have used a clinical definition of OA. The objectives are: (1) To examine the cross-sectional association between clinical OA and fair-to-poor SRH in the general population; (2) To examine whether this association differs between countries; (3) To examine whether physical function is a mediator in the association between clinical OA and SRH. METHODS Baseline data of the European Project on OSteoArthritis (EPOSA) were used, which includes pre-harmonized data from six European cohort studies (n = 2709). Clinical OA was defined according to the American College of Rheumatology criteria. SRH was assessed using one question: How is your health in general? Physical function was assessed using the Western Ontario and McMaster Universities OA Index and Australian/Canadian OA Hand Index. RESULTS The prevalence of fair-to-poor SRH ranged from 19.8 % in the United Kingdom to 63.5 % in Italy. Although country differences in the strength of the associations were observed, clinical OA of the hip, knee and hand were significantly associated with fair-to-poor SRH in five out of six European countries. In most countries and at most sites, the association between clinical OA and fair-to-poor SRH was partly or fully mediated by physical function. CONCLUSIONS Clinical OA at different sites was related to fair-to-poor SRH in the general population. Most associations were (partly) mediated by physical functioning, indicating that deteriorating physical function in patients with OA should be a point of attention in patient care.
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Affiliation(s)
- N M van Schoor
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - S Zambon
- Department of Medical and Surgical Sciences, University of Padova, Padua, Italy
- National Research Council, Aging Branch, Institute of Neuroscience, Padua, Italy
| | - M V Castell
- Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK
| | - M Denkinger
- Bethesda Geriatric Clinic, University of Ulm, Ulm, Germany
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK
| | - M H Edwards
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK
| | - F Herbolsheimer
- Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Ulm, Germany
| | - S Maggi
- National Research Council, Aging Branch, Institute of Neuroscience, Padua, Italy
| | - M Sánchez-Martinez
- Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - N L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - R Peter
- Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Ulm, Germany
| | - L A Schaap
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - J J M Rijnhart
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - S van der Pas
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - D J H Deeg
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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