Natural history of pain and disability among African–Americans and Whites with or at risk for knee osteoarthritis: A longitudinal study
AffiliationUniv Arizona, Dept Med, Div Rheumatol
Univ Arizona, Arizona Arthrit Ctr
Univ Arizona, Mel & Enid Zuckerman Coll Publ Hlth, Dept Epidemiol & Biostat
MetadataShow full item record
PublisherELSEVIER SCI LTD
CitationE.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.
JournalOSTEOARTHRITIS AND CARTILAGE
Rights© 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Collection InformationThis 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 firstname.lastname@example.org.
AbstractObjective: 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.
Note12 month embargo; published online: 2 February 2018
VersionFinal accepted manuscript
SponsorsNIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) [K23AR067226, R01AR066601]