Environmental barriers increase difficulty for adults with knee osteoarthritis

Higher perceived mobility barriers in the environment were associated with increased risk in difficulty with life situation engagement in adults with knee osteoarthritis, according to data published in Arthritis Care & Research.

Why aquatic exercise is making a splash with health conscious adults. McMaster Optimal Aging Portal

by Will Offit, Healio February 10, 2017

“Older adults spend more time in their neighborhoods and face changes in vision, hearing and function over time, which make them more vulnerable to environmental conditions,” Molly W. Vaughan PhD DPT, research associate at Boston University Sargent College of Health and Rehabilitation, and colleagues wrote. “If participation restriction occurs, quality of life and social isolation may decline, resulting in institutionalization and an inability to ‘age in place.’ Modifying features of the physical environment, such as community mobility barriers, may offset this negative health outcome among older adults with or at risk of knee osteoarthritis.”

Vaughan and colleagues assessed 322 participants from the Multicenter Osteoarthritis Study (MOST), who completed the Instrumental role subscale of the Late Life Disability Index (LLDI) questionnaire at baseline, 30 months and 60 months.

The researchers defined participation restriction, or difficulty with life situation engagement, as an LLDI score of less than 67.6 out of 100. Researchers used the Home and Community Environment questionnaire from the MOST Knee Pain & Disability study to evaluate patient-reported environmental features.

They used robust Poisson regression to calculate the association between participation restriction at 60 months and high community mobility barriers and high transportation facilitators.

Researchers found 27% of the study group developed participation restriction by 60 months after baseline, which was significantly associated with high community mobility barriers (RR = 1.8) after adjustment for covariates. High transportation facilitators at baseline were also associated, though not significantly, with reduced participation restriction at 60 months.

“Our findings concur with current ‘aging in place’ initiatives to decrease environmental barriers in cities in order to promote optimal living and health outcomes for older adults and suggest that these initiatives are important for people with knee osteoarthritis,” Vaughan said. “An age-friendly city, according to the World Health Organization, includes physical environmental facilitators similar to predictors in our study, such as accessibility, safety and access to certain services (e.g., transportation, parks, recreational facilities) and promotes opportunities for participation and a better quality of life.”

Source Healio

Perceived Community Environmental Factors Predict Risk of 5-year Participation Restriction among Older Adults with or at Risk of Knee Osteoarthritis: the MOST Study, Vaughan MW, Felson DT, LaValley MP, Orsmond GI, Niu J, Lewis CE, Segal NA, Nevitt MC, Keysor JJ. Arthritis Care Res (Hoboken). 2017 Jan 27. doi: 10.1002/acr.23085. [Epub ahead of print]

Associations between perceived neighbourhood problems and quality of life in older adults with and without osteoarthritis: Results from the Hertfordshire Cohort Study, Timmermans EJ, van der Pas S2, Schaap LA, Cooper C, Edwards MH, Gale CR, Deeg DJ, Dennison EM. Health Place. 2017 Jan;43:144-150. doi: 10.1016/j.healthplace.2016.11.013. Epub 2017 Jan 3.

Also see
Researching Age-friendly Cities: new guide and film to working with older people as co-researchers in World Health Organization
More than half of children with arthritis have restriction with physical activity in Healio Rheumatology

Participation in Leisure Activities among Canadian Children with Arthritis: Results from a National Representative Sample, Cavallo S, Majnemer A, Mazer B, Chilingaryan G, Ehrmann Feldman D. J Rheumatol. 2015 Jun;42(6):1002-10. doi: 10.3899/jrheum.131377. Epub 2015 May 15.

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