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    Natural history of pain and disability among African–Americans and Whites with or at risk for knee osteoarthritis: A longitudinal study

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    Name:
    Race_OA_Pain_Progression_01171 ...
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    Description:
    Final Accepted Manuscript
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    Author
    Vina, E.R.
    Ran, D.
    Ashbeck, E.L.
    Kwoh, C.K.
    Affiliation
    Univ Arizona, Dept Med, Div Rheumatol
    Univ Arizona, Arizona Arthrit Ctr
    Univ Arizona, Mel & Enid Zuckerman Coll Publ Hlth, Dept Epidemiol & Biostat
    Issue Date
    2018-04
    Keywords
    Osteoarthritis
    Knee osteoarthritis
    Race
    Outcome measures
    Pain
    Longitudinal
    
    Metadata
    Show full item record
    Publisher
    ELSEVIER SCI LTD
    Citation
    E.R. Vina, D. Ran, E.L. Ashbeck, C.K. Kwoh, Natural history of pain and disability among African–Americans and Whites with or at risk for knee osteoarthritis: A longitudinal study, Osteoarthritis and Cartilage, 26(4), pp 471-479, https://doi.org/10.1016/j.joca.2018.01.020.
    Journal
    OSTEOARTHRITIS AND CARTILAGE
    Rights
    © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    Objective: Compare knee pain and disability between African Americans (AAs) and Whites (WHs), with or at risk of knee osteoarthritis (KOA), over 9 years, and evaluate racial disparities in KOA-related symptoms across socioeconomic and clinical characteristics. Design: Osteoarthritis Initiative (OAI) participants were evaluated annually over 9 years for pain and disability, assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and a numerical rating scale (NRS) for knee pain severity. Mean annual WOMAC pain, NRS pain, and WOMAC disability levels were estimated by race using mixed effects models, adjusted for age, sex, education, marital status, body mass index (BMI), depression, and baseline Kellgrene-Lawrence grade score. Race-specific mean WOMAC pain scores were also estimated in analyses stratified by socioeconomic and clinical characteristics. Results: AAs reported worse mean WOMAC pain compared to WHs at baseline (3.69 vs 2.20; P <= 0.0001) and over 9 years of follow-up, with similar disparities reflected in NRS pain severity and WOMAC disability. Radiographic severity did not account for the differences in pain and disability, as substantial and significant racial disparities were observed after stratification by Kellgrene-Lawrence grade. Depression and low income exacerbated differences in WOMAC pain between AAs and WHs by a substantial and significant magnitude. Conclusions: Over 9 years of follow-up, AAs reported persistently greater KOA symptoms than WHs. Socioeconomically and clinically disadvantaged AAs reported the most pronounced disparities in pain and disability. (C) 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
    Note
    12 month embargo; published online: 2 February 2018
    ISSN
    10634584
    PubMed ID
    29408279
    DOI
    10.1016/j.joca.2018.01.020
    Version
    Final accepted manuscript
    Sponsors
    NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) [K23AR067226, R01AR066601]
    Additional Links
    http://linkinghub.elsevier.com/retrieve/pii/S1063458418300797
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.joca.2018.01.020
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