This prevalence survey is the first phase of a planned prospective cohort of osteoarthritis (OA) of the hip and the knee in the rural, Southern community of Johnston County, North Carolina. We will compare prevalence of radiographic OA, knee and hip symptoms, and functional impairment from OA in Caucasian and African-American adults and describe incidence of symptoms. this will be accomplished by radiographic, symptomatic, and functional assessments of 3600 adults aged 45 years and older in six townships of Johnston County. The role of physical demands of work in present and past occupations, as measured by Dictionary of Occupational Titles and by self-report will be evaluated in each of the above OA outcomes, with the hypothesis that occupations with heavy physical demands and repetitive joint motion are associated with higher prevalence of OA. Particular attention will be paid to activities of homemakers. Other risk factors, such as age, race, gender, education, obesity, joint trauma, etc. will be examined as well in this context. In the differentiation between radiographic OA and symptoms, we will evaluate the hypothesis that psychosocial factors (such as education, depression, learned helplessness, social support, and family cohesion) are as important as radiographic and clinical indicators of disease severity in determining symptoms and disability. Descriptive statistics and standard estimates of prevalence and incidence will be calculated. Stratified analysis and multiple logistic regression will be used to define the relationship between a putative risk factor and outcome. This is the first prevalence survey and prospective cohort of OA of the hip and knee in the rural South, an area with increased risk for development of musculoskeletal problems and their resultant disabilities (1,2). It is also the first study of its type to examine these issues with particular attention to African-Americans. This proposal builds upon and extends work underway since 1990 with funding from the Centers for Disease Control; protocols, data collection instruments, and logistics to carry out the work have already been designed, implemented, and revised. Five- hundred twenty-five participants have been enrolled as of October 1992. By utilizing a population at high risk in a community with an established research facility, this project can maximize the information obtained per dollar cost.
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