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Knee Osteoarthritis and the Risk of Medically Treated Injurious Falls Among Older Adults: A Community‐Based US Cohort Study
Author(s) -
Barbour Kamil E.,
Sagawa Naoko,
Boudreau Robert M.,
Winger Mary E.,
Cauley Jane A.,
Nevitt Michael C.,
Fujii Tomoko,
Patel Kushang V.,
Strotmeyer Elsa S.
Publication year - 2019
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23725
Subject(s) - medicine , osteoarthritis , hazard ratio , knee pain , proportional hazards model , physical therapy , confidence interval , cohort , cohort study , alternative medicine , pathology
Objective The risk of falls among adults with knee osteoarthritis ( OA ) has been documented, yet, to our knowledge no studies have examined knee OA and the risk of medically treated injurious falls (overall and by sex), which is an outcome of substantial clinical and public health relevance. Methods Using data from the Health Aging and Body Composition Knee Osteoarthritis Substudy, a community‐based study of white and African American older adults, we tested associations between knee OA status and the risk of injurious falls among 734 participants with a mean ± SD age of 74.7 ± 2.9 years. Knee radiographic OA ( ROA ) was defined as having a Kellgren‐Lawrence grade of ≥2 in at least 1 knee. Knee symptomatic ROA ( sROA ) was defined as having both ROA and pain symptoms in the same knee. Injurious falls were defined using a validated diagnosis code algorithm from linked Medicare fee‐for‐service claims. Cox regression modeling was used to estimate hazard ratios ( HR s) and 95% confidence intervals (95% CI s). Results The mean ± SD follow‐up time was 6.59 ± 3.12 years. Of the 734 participants, 255 (34.7%) had an incident injurious fall over the entire study period. In the multivariate model, compared with those without ROA or pain, individuals with sROA ( HR 1.09 [95% CI 0.73–1.65]) did not have a significantly increased risk of injurious falls. Compared with men without ROA or pain, men with sROA ( HR 2.57 [95% CI 1.12–5.91]) had a significantly higher risk of injurious falls. No associations were found for women or by injurious fall type. Conclusion Knee sROA was independently associated with an increased risk of injurious falls in older men, but not in older women.