Associations Of The Joint Pain And Osteoarthritis In Lower Limbs With Quality Of Life Among Retired Workers

The joint pain and osteoarthritis in lower limbs are common diseases among middle-aged and elderly people,and it is an important cause of disability.With the progress of the aging population,the impacts of joint pain and osteoarthritis of lower limbs on quality of life(QOL)attracted a lot of attention,but few studies had explored the associations.In that case,our study aimed to estimate the impacts of the joint pain and osteoarthritis of lower limbs on QOL.Objective: To investigate the circumstances of retired worker' s suffering from joint pain and osteoarthritis in lower limbs;to collect the information of QOL by questionnaire;to analyze the associations of the joint pain and osteoarthritis in lower limbs with QOL.Methods: Cross-sectional study was implemented in retired workers who undergo a medical examination in 2013.Standard questionnaire and physical examinations were conducted for all subjects to collect the basic information and joint status in lower limbs.QOL was evaluated with questionnaires designed according to the WHOQOL-BREF.Pain complains were diagnosed if any participants had experienced joint pain or stiffness in at least one side of lower limb during the last year.OA in lower limbs was diagnosed if they met the following two standards:(1)with pain complains;(2)X-ray radiographs showed a Kellgren & Lawrence grade ? 2 in at least one side of lower limb.The joint of lower limbs included knee and hip joint.Descriptive statistical analysis were used to describe the distributions of the pain and osteoarthritis in lower limbs.Students t-tests and analysis of variance were used to compared the difference of life quality in different groups.Logistic regression models were performed to explore the potential risk factors of the joint pain and osteoarthritis in lower limbs.Generalized linear models were used to build the associations of the joint pain and osteoarthritis in lower limbs with QOL,and to explore the factors which may influence the QOL among retired workers.All statistical analyses were performed using SAS 9.4 software(SAS Institute,Cary,NC),and a two-sided P-value < 0.05 was regarded as statistically significant.Results:(1)The present study included 12300 individuals with a mean age of 64.47±8.20.Among them,5525(44.92%)participants were man,8858(72.02%)participants aged 50-70.The prevalence of knee-joint pain,knee osteoarthritis,hip-joint pain,and hip osteoarthritis were 38.46%,6.68%,4.93%,and 2.84%,respectively.(2)Age,gender and obesity could be potential risk factors of joint pain and osteoarthritis in lower limbs.The risk of knee-joint pain(OR=1.39,95%CI=1.26-1.53)? knee OA(OR=1.97,95%CI=1.63-2.37)?hip-joint pain(OR=2.05,95%CI=1.53-2.74)and hip OA(OR=2.05,95%CI=1.53-2.74)increased with the age;the risk of knee-joint pain,knee OA,hip-joint pain and hip OA increased with obesity,and the OR were 1.63(1.45-1.84),2.13(1.75-2.60),1.38(1.08-1.76)and 1.26(0.92-1.74),respectively;when compared with man,woman have a higher risk of knee-joint pain(OR=2.47,95%CI=2.22-2.75),knee OA(OR=2.72,95%CI=2.20-2.38),hip-joint pain(OR=2.06,95%CI =1.62-2.62)and hip OA(OR=2.31,95%CI =1.68-3.17).Drinking were significantly associated with knee-joint pain(OR=1.23,95%CI =1.12-1.35)and knee OA(OR=1.40,95%CI =1.16-1.68).;smoking were significantly associated with hip OA(OR=1.42,95%CI=1.02-1.98);occupational hazards were significantly associated with knee-joint pain(OR=1.15,95%CI=1.06-1.24)and hip-joint pain(OR=1.01,95%CI=1.01-1.42).(3)No significant difference was found between male(74.67±10.59)and female(74.56±11.03)on QOL total score.Old age,female,obesity,high education,chronic disease would reduce the QOL total score.Exercise,good status of marital status would increase the QOL total score.As for the associations of the joint pain and osteoarthritis in lower limbs with QOL,results showed that the QOL total score was significantly lower in individuals who had joint pain or osteoarthritis in lower limbs.Knee-joint pain,knee OA,hip-joint pain or hip OA were significantly associated with a 2.80,2.15,3.27,or 3.25 reduction in QOL total score after adjusting for potential confounders.We further analyzed the relationship between joint pain,osteoarthritis and the four domains in QOL.Results showed that knee-joint pain was significantly associated with four domains in QOL.It had the greatest effect on physical health domain,causing a reduction of 5.77 in physical health domain,2.14 in psychological health domain,1.63 in social relationship domain,and 1.60 in environment domain.Knee OA caused a reduction of 7.27 in physical health domain,1.04 in psychological health domain.Hip-joint pain and hip OA were significantly associated with four domains in QOL.Hip-joint pain caused a reduction of 4.16 in physical health domain,2.16 in psychological health domain,2.54 in social relationship domain,and 4.03 in environment domain;hip OA caused a reduction of 5.60 in physical health domain,1.94 in psychological health domain,2.10 in social relationship domain,and 3.24 in environment domain.Obviously,the reduction in QOL total score was more pronounced in physical health domain among participants with OA than participants with pain complains,less pronounced in psychological health,social relationship and environment domain.Conclusions:(1)The prevalence of knee-joint in retired workers was more than 35%,and the prevalence of knee OA,hip-joint pain and hip OA were between 2.8% and 6.7%.(2)Old age,female,obesity,drinking,smoking and occupational hazard were potential risk factors of pain and osteoarthritis in lower limbs.(3)Knee-joint pain was significantly associated with a decline in QOL total score and the QOL four domains score,and it had the greatest effect on physical health,the least effect on psychological health.;Knee OA was significantly associated with a decline in QOL total score,physical health domain and psychological health domain.(4)Hip-joint pain and hip OA were significantly associated with a decline in QOL total score and the QOL four domains score.It had the greatest effect on physical health domain,the least effect on social relationship domain.