Распространенность остеоартрита и его ассоциации с гериатрическими синдромами у лиц старше 65 лет: данные российского эпидемиологического исследования ЭВКАЛИПТ
Распространенность остеоартрита и его ассоциации с гериатрическими синдромами у лиц старше 65 лет: данные российского эпидемиологического исследования ЭВКАЛИПТ
Наумов А.В., Воробьева Н.М., Ховасова Н.О., Мороз В.И., Мешков А.Д., Маневич Т.М., Ткачева О.Н., Котовская Ю.В., Селезнева Е.В., Овчарова Л.Н. Распространенность остеоартрита и его ассоциации с гериатрическими синдромами у лиц старше 65 лет: данные российского эпидемиологического исследования ЭВКАЛИПТ. Терапевтический архив. 2021;93(12):1482–1490.
DOI: 10.26442/00403660.2021.12.201268
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Naumov AV, Vorobyeva NM, Khovasova NO, Moroz VI, Meshkov AD, Manevich TM, Tkacheva ON, Kotovskaya YuV, Selezneva EV, Ovcharova LN. The prevalence of osteoarthritis and its association with geriatric syndromes in people over 65: data from the Russian epidemiological study EVKALIPT. Terapevticheskii Arkhiv (Ter. Arkh.). 2021;93(12):1482–1490. DOI: 10.26442/00403660.2021.12.201268
Распространенность остеоартрита и его ассоциации с гериатрическими синдромами у лиц старше 65 лет: данные российского эпидемиологического исследования ЭВКАЛИПТ
Наумов А.В., Воробьева Н.М., Ховасова Н.О., Мороз В.И., Мешков А.Д., Маневич Т.М., Ткачева О.Н., Котовская Ю.В., Селезнева Е.В., Овчарова Л.Н. Распространенность остеоартрита и его ассоциации с гериатрическими синдромами у лиц старше 65 лет: данные российского эпидемиологического исследования ЭВКАЛИПТ. Терапевтический архив. 2021;93(12):1482–1490.
DOI: 10.26442/00403660.2021.12.201268
________________________________________________
Naumov AV, Vorobyeva NM, Khovasova NO, Moroz VI, Meshkov AD, Manevich TM, Tkacheva ON, Kotovskaya YuV, Selezneva EV, Ovcharova LN. The prevalence of osteoarthritis and its association with geriatric syndromes in people over 65: data from the Russian epidemiological study EVKALIPT. Terapevticheskii Arkhiv (Ter. Arkh.). 2021;93(12):1482–1490. DOI: 10.26442/00403660.2021.12.201268
Обоснование. Остеоартрит (ОА) у пациентов пожилого и старческого возраста является не только распространенным, но и одним из главных заболеваний, влияющих на продолжительность активной жизни, ее качество, появление зависимостей и потерю автономности. Данные о связи ОА с гериатрическими синдромами (ГС) в нашей стране крайне скудны. Цель. Оценить распространенность ОА и проанализировать его ассоциации с ГС у лиц в возрасте ≥65 лет. Материалы и методы. В исследование включены 4308 человек (30% мужчин) в возрасте от 65 до 107 лет, проживающих в 11 регионах России. Больных разделили на 2 группы: с ОА (n=2464) и без ОА (n=1821). Всем пациентам выполнена комплексная гериатрическая оценка. Результаты. Распространенность ОА составила 57,6%. С возрастом частота ОА значимо возрастала. По результатам комплексной гериатрической оценки у пациентов с ОА были ниже скорость ходьбы, сумма баллов по шкалам Бартела, Лоутона и краткой батарее тестов физического функционирования и выше – сумма баллов по гериатрической шкале депрессии и шкале «Возраст не помеха». Пациенты с ОА ниже оценивали качество жизни и состояние здоровья и выше – интенсивность болевого синдрома. Пациенты с ОА чаще использовали любые вспомогательные средства, за исключением инвалидного кресла. У пациентов с ОА наиболее распространенными ГС были хронический болевой синдром (92%), синдром старческой астении (64%), базовая (66%) и инструментальная (56%) зависимость в повседневной жизни, когнитивные нарушения (62%), вероятная депрессия (51%) и недержание мочи (50%). Однофакторный регрессионный анализ продемонстрировал, что ОА ассоциируется с повышением риска ряда ГС в 1,2–3,0 раза и снижением риска мальнутриции на 28%. Заключение. ОА широко распространен в популяции пожилых людей. Наличие ОА ассоциируется с рядом ГС, связанных с потерей автономности.
Aim. To estimate the prevalence of OA and to analyze its associations with HS in persons aged ≥65 years. Materials and methods. The study included 4308 people (30% of men) aged 65 to 107 years, living in 11 regions of Russia. The patients were divided into 2 groups: with OA (n=2464) and without OA (n=1821). All patients underwent a comprehensive geriatric assessment. Results. The prevalence of OA was 57.6%. With age, the frequency of OA increased significantly. According to the results of a comprehensive geriatric assessment, patients with OA had lower walking speed, the sum of points on the Bartel, Lawton scales and a short battery of physical functioning tests and higher – the sum of points on the geriatric scale of depression and the age is not a hindrance scale. Patients with OA rated the quality of life and health status lower and higher – the intensity of pain syndrome. Patients with OA were more likely to use any assistive device, with the exception of a wheelchair. In patients with OA, the most common HS were chronic pain syndrome (92%), senile asthenia syndrome (64%), basic (66%) and instrumental (56%) dependence in everyday life, cognitive impairment (62%), probable depression (51%) and urinary incontinence (50%). Univariate regression analysis showed that OA is associated with a 1.2–3.0-fold increase in the risk of a number of GS and a 28% decrease in the risk of malnutrition. Conclusion. OA is widespread in the elderly population. The presence of OA is associated with a number of GS associated with loss of autonomy.
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________________________________________________
1. Sacitharan PK. Ageing and Osteoarthritis. Subcell Biochem. 2019;91:123-59. DOI:10.1007/978-981-13-3681-2_6
2. Mandl LA. Osteoarthritis year in review 2018: clinical. Osteoarthritis Cartilage. 2019;27(3):359-64. DOI:10.1016/j.joca.2018.11.001
3. Leyland KM, Gates LS, Sanchez-Santos MT, et al.; PCCOA Steering Committee. Knee osteoarthritis and time-to all-cause mortality in six community-based cohorts: an international meta-analysis of individual participant-level data. Aging Clin Exp Res. 2021;33(3):529-45. DOI:10.1007/s40520-020-01762-2
4. Sharma PK, Reddy BM, Ganguly E. Frailty Syndrome among oldest old Individuals, aged ≥80 years: Prevalence & Correlates. J Frailty Sarcopenia Falls. 2020;5(4):92-101. DOI:10.22540/JFSF-05-092
5. Thinuan P, Siviroj P, Lerttrakarnnon P, Lorga T. Prevalence and Potential Predictors of Frailty among Community-Dwelling Older Persons in Northern Thailand: A Cross-Sectional Study. Int J Environ Res Public Health. 2020;17(11):4077. DOI:10.3390/ijerph17114077
6. Yoshimura N, Nakamura K, Tanaka S. Epidemiology of the Locomotive Organ Diseases. Health Issues and Care System for the Elderly. 2019:69-81.
DOI:10.1007/978-981-13-1762-0_5
7. Tkacheva ON, Kotovskaya YuV, Runikhina NK, et al. Clinical guidelines on frailty. Russian Journal of Geriatric Medicine. 2020;1:11-46 (in Russian).
DOI:10.37586/2686-8636-1-2020-11-46
8. Arora M, Sun CL, Ness KK, et al. Physiologic Frailty in Nonelderly Hematopoietic Cell Transplantation Patients: Results From the Bone Marrow Transplant Survivor Study. JAMA Oncol. 2016;2(10):1277-86. DOI:10.1001/jamaoncol.2016.0855
9. Cacciatore F, Della-Morte D, Basile C, et al. Long-term mortality in frail elderly subjects with osteoarthritis. Rheumatology (Oxford). 2014;53(2):293-9. DOI:10.1093/rheumatology/ket348
10. Meessen JMTA, Leichtenberg CS, Tilbury C, et al. Frailty in end-stage hip or knee osteoarthritis: validation of the Groningen Frailty Indicator (GFI) questionnaire. Rheumatol Int. 2018;38(5):917-24. DOI:10.1007/s00296-017-3868-1
11. Salaffi F, Farah S, Di Carlo M. Frailty syndrome in rheumatoid arthritis and symptomatic osteoarthritis: an emerging concept in rheumatology. Acta Biomed. 2020;91(2):274-96. DOI:10.23750/abm.v91i2.9094
12. Knox PJ, Coyle PC, Pugliese JM, et al. Hip osteoarthritis signs and symptoms are associated with increased fall risk among community-dwelling older adults with chronic low back pain: a prospective study. Arthritis Res Ther. 2021;23(1):71. DOI:10.1186/s13075-021-02455-5
13. De Ceuninck F, Fradin A, Pastoureau P. Bearing arms against osteoarthritis and sarcopenia: when cartilage and skeletal muscle find common interest in talking together. Drug Discov Today. 2014;19(3):305-11. DOI:10.1016/j.drudis.2013.08.004
14. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-83. DOI:10.1016/0021-9681(87)90171-8
15. Tkacheva ON, Kotovskaya YuV, Runikhina NK, et al. Clinical guidelines frailty. Part 2. Russian Journal of Geriatric Medicine. 2020;2:115-30 (in Russian).
DOI:10.37586/2686-8636-2-2020-115-130
16. Vorobyeva NM, Tkacheva ON, Kotovskaya YuV, et al. Russian epidemiological study EVKALIPT: protocol and basic characteristics of participants. Russian Journal of Geriatric Medicine. 2021;1:35-43 (in Russian). DOI:10.37586/2686-8636-1-2021-35-43
17. Litwic A, Edwards MH, Dennison EM, Cooper C. Epidemiology and burden of osteoarthritis. Br Med Bull. 2013;105:185-99. DOI:10.1093/bmb/lds038
18. Murphy L, Schwartz TA, Helmick CG, et al. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008;59(9):1207-13. DOI:10.1002/art.24021
19. Castell MV, van der Pas S, Otero A, et al. Osteoarthritis and frailty in elderly individuals across six European countries: results from the European Project on OSteoArthritis (EPOSA). BMC Musculoskelet Disord. 2015;16:359. DOI:10.1186/s12891-015-0807-8
20. Prieto-Alhambra D, Judge A, Javaid MK, et al. Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: influences of age, gender and osteoarthritis affecting other joints. Ann Rheum Dis. 2014;73(9):1659-64. DOI:10.1136/annrheumdis-2013-203355
21. Jeon H, Lee SU, Lim JY, et al. Low skeletal muscle mass and radiographic osteoarthritis in knee, hip, and lumbar spine: a cross-sectional study. Aging Clin Exp Res. 2019;31(11):1557-62. DOI:10.1007/s40520-018-1108-5
22. Misra D, Fielding RA, Felson DT, et al.; MOST study. Risk of Knee Osteoarthritis With Obesity, Sarcopenic Obesity, and Sarcopenia. Arthritis Rheumatol. 2019;71(2):232-7. DOI:10.1002/art.40692
23. Doré AL, Golightly YM, Mercer VS, et al. Lower-extremity osteoarthritis and the risk of falls in a community-based longitudinal study of adults with and without osteoarthritis. Arthritis Care Res (Hoboken). 2015;67(5):633-9. DOI:10.1002/acr.22499
24. Hampton SN, Nakonezny PA, Richard HM, Wells JE. Pain catastrophizing, anxiety, and depression in hip pathology. Bone Joint J. 2019;101-B(7):800-7.
DOI:10.1302/0301-620X.101B7.BJJ-2018-1309.R1
25. Rathbun AM, Shardell MD, Ryan AS, et al. Association between disease progression and depression onset in persons with radiographic knee osteoarthritis. Rheumatology (Oxford). 2020;59(11):3390-9. DOI:10.1093/rheumatology/keaa141
26. Tanaka R, Ozawa J, Kito N, Moriyama H. Efficacy of strengthening or aerobic exercise on pain relief in people with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil. 2013;27(12):1059-71. DOI:10.1177/0269215513488898
27. Dean E, Hansen RG. Prescribing optimal nutrition and physical activity as “first-line” interventions for best practice management of chronic low-grade inflammation associated with osteoarthritis: evidence synthesis. Arthritis. 2012;2012:560634. DOI:10.1155/2012/560634
28. Grässel S, Muschter D. Recent advances in the treatment of osteoarthritis. F1000Res. 2020;9:F1000 Faculty Rev-325. DOI:10.12688/f1000research.22115.1
29. Bruyère O, Honvo G, Veronese N, et al. An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin Arthritis Rheum. 2019;49(3):337-50. DOI:10.1016/j.semarthrit.2019.04.008
30. Largo R, Alvarez-Soria MA, Díez-Ortego I, et al. Glucosamine inhibits IL-1beta-induced NFkappaB activation in human osteoarthritic chondrocytes. Osteoarthritis Cartilage. 2003;11(4):290-8. DOI:10.1016/s1063-4584(03)00028-1
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1 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
2 ФГАОУ ВО «Национальный исследовательский университет “Высшая школа экономики”», Москва, Россия
*nanton78@gmail.com
________________________________________________
Anton V. Naumov*1, Natalya M. Vorobyeva1, Natalia O. Khovasova1, Viktoriia I. Moroz1, Alexey D. Meshkov1, Tatiana M. Manevich1, Olga N. Tkacheva1, Yulia V. Kotovskaya1, Elena V. Selezneva2, Lilia N. Ovcharova2
1 Pirogov Russian National Research Medical University, Moscow, Russia;
2 National Research University “Higher School of Economics”, Moscow, Russia
*nanton78@gmail.com