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(Unpublished)
This is the latest version of this item.
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: |
|
| ETD Committee: |
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| 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 |
Available Versions of this Item
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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. (deposited 12 May 2021 18:07)
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