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Examining the Association of Chronic Health Conditions and Adverse Health Outcomes: Knee OA and Recurrent Falls Knee OA and Mobility Limitations Sarcopenia and Fractures

Harris, Rebekah (2021) Examining the Association of Chronic Health Conditions and Adverse Health Outcomes: Knee OA and Recurrent Falls Knee OA and Mobility Limitations Sarcopenia and Fractures. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Background: The older adult population is growing. Older age is accompanied by multimorbidity.[1] The declines in physical function and mobility that coincide with aging and chronic conditions is a significant reason that our rapidly growing aging population is a public health concern. [2]
Objectives: This dissertation examined the associations of (1) knee osteoarthritis with recurrent falls (2) knee osteoarthritis with mobility limitations and (3) sarcopenia with fractures (any clinical, hip, and major osteoporotic).
Methods: Study populations included community dwelling adults from the (1) Osteoarthritis Initiative Study (N=4,976, age=45-79 years) and (2) Osteoporotic Fractures in Men Study (MrOS) (N=5,995, mean age= 73.7 (+/-5.9)). Generalized estimating equations were applied to aim 1 and 2 and cox proportional hazards models were applied to aim 3.
Results:
Older adults (≥age 65) with KOA were at higher odds of recurrent falls in comparison to individuals without KOA in models adjusting for known covariates (possible OA OR= 2.22, 95% CI= 1.09-4.52; mild OA OR=2.48, 95% CI= 1.34-4.62; unilateral moderate-severe OA OR= 2.84, 95% CI= 1.47- 5.50; bilateral moderate-severe OA OR= 2.52, 95% CI= 1.13-5.62). Middle aged adults with KOA did not have increased odds of recurrent falls in comparison to those without KOA except for possible KOA (OR= 1.86, 95% CI=1.01-2.78) (KLseverity*age interaction = 0.025).
Overall, 1,413 men had a fracture during follow-up. Slow walking speed was associated with an increased risk for any HR=1.39, 1.05-1.84; hip HR= 2.37, 1.54-3.63; and major osteoporotic, HR= 1.89, 1.34-2.67 in multi-variate adjusted models. Low lean mass and low grip strength were not significantly associated with fracture.
Conclusion: These findings suggest that there are targetable impairments at the body function and structure and at the activities level of older adults to prevent future limitations in participation and disability. The public health relevance of these findings are that identifying potential earlier impairments that are known to lead to disability may inform prevention efforts to prevent incident cases of disability.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Harris, Rebekahrjh86@pitt.edurjh86
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairCauley, Janejcauley@edc.pitt.edujcauley
Committee MemberStrotmeyer, Elsastrotmeyer@edc.pitt.edustrotmeyer
Committee MemberBrach, Jenniferjbrach@pitt.edujbrach
Committee MemberBoudreau, Robertboudreaur@edc.pitt.eduboudreaur
Committee MemberKwoh, C.Kentckwoh@pitt.educkwoh
Date: 12 May 2021
Date Type: Publication
Defense Date: 6 April 2021
Approval Date: 12 May 2021
Submission Date: 30 April 2021
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 269
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Aging, Physical Function, Falls
Date Deposited: 12 May 2021 18:07
Last Modified: 12 May 2023 05:15
URI: http://d-scholarship.pitt.edu/id/eprint/41026

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