The goal of this ancillary proposal to the Johnston County Osteoarthritis (JoCo OA) Project: Arthritis and Disability (1U01DP003206-01 - funded by the CDC) is to create a repository of enhanced vital status, date and cause of death for participants during their current follow-up and to examine the contribution of knee and/or hip OA to mortality in non-Hispanic African-American (AA) and Caucasian men and women. The parent study was designed to encompass multiple aspects of the OA process from the biomedical to the psychosocial and from the pre-clinical to disability. Examining mortality in this cohort with up to 25 years of observation and extensive OA and chronic conditions data over multiple time points provides the perfect opportunity to answer these questions in ways other studies could not, and additionally, enhance the parent project. The goal will be accomplished with these 3 specific aims and a 4th exploratory aim: 1) to create a repository of enhanced vital status data in the 20+ year follow-up of the JoCo OA with the date and cause of death;2) to determine whether knee and/or hip OA at baseline is associated with excess all-cause or disease-specific mortality, independent of concomitant comorbidities and obesity, and whether it is modified separately by gender, by race, and by socioeconomic status;3) to evaluate the combined impact of OA and obesity, diabetes mellitus or cardiovascular disease on all-cause and disease specific mortality;and 4) to explore whether OA severity and persistence of symptoms of OA impacts all-cause and disease-specific mortality.
Symptomatic knee and/or hip OA poses a significant public health problem due to its impact on pain, mobility and disability, and the potential barrier it presents to physical activity among adults with diabetes mellitus and cardiovascular disease. In the limited number of studies that have examined mortality among those with knee and/or hip OA, there is moderate evidence of increased mortality in individuals with OA compared with the general population. However, most of these studies have methodological concerns. Given the prevalence and projected increase of OA in the US and global population, a more thorough understanding of OA-attributable mortality will have a significant impact on policy and the development of new clinical models of care for this condition.