Within-person pain variability and physical activity in older adults with osteoarthritis from six European countries

Erik J Timmermans, Elisa J de Koning, Natasja M van Schoor, Suzan van der Pas, Michael D Denkinger, Elaine M Dennison, Stefania Maggi, Nancy L Pedersen, Ángel Otero, Richard Peter, Cyrus Cooper, Paola Siviero, Maria Victoria Castell, Florian Herbolsheimer, Mark Edwards, Federica Limongi, Dorly J H Deeg, Laura A Schaap, Erik J Timmermans, Elisa J de Koning, Natasja M van Schoor, Suzan van der Pas, Michael D Denkinger, Elaine M Dennison, Stefania Maggi, Nancy L Pedersen, Ángel Otero, Richard Peter, Cyrus Cooper, Paola Siviero, Maria Victoria Castell, Florian Herbolsheimer, Mark Edwards, Federica Limongi, Dorly J H Deeg, Laura A Schaap

Abstract

Background: This study examines the association of both pain severity and within-person pain variability with physical activity (PA) in older adults with osteoarthritis (OA).

Methods: Data from the European Project on OSteoArthritis were used. At baseline, clinical classification criteria of the American College of Rheumatology were used to diagnose OA in older adults (65-85 years). At baseline and 12-18 months follow-up, frequency and duration of participation in the activities walking, cycling, gardening, light and heavy household tasks, and sports activities were assessed with the Longitudinal Aging Study Amsterdam Physical Activity Questionnaire. Physical activity was calculated in kcal/day, based on frequency, duration, body weight and the metabolic equivalent of each activity performed. At baseline and 12-18 months follow-up, pain severity was assessed using the pain subscales of the Western Ontario and McMaster Universities OA Index and the Australian/Canadian Hand OA Index. Within-person pain variability was assessed using two-week pain calendars that were completed at baseline, 6 months follow-up and 12-18 months follow-up.

Results: Of all 669 participants, 70.0% were women. Sex-stratified multiple linear regression analyses showed that greater pain severity at baseline was cross-sectionally associated with less PA in women (Ratio = 0.95, 95% CI = 0.90-0.99), but not in men (Ratio = 0.99, 95% CI = 0.85-1.15). The longitudinal analyses showed a statistically significant inverse association between pain severity at baseline and PA at follow-up in women (Ratio = 0.94, 95% CI = 0.89-0.99), but not in men (Ratio = 1.00, 95% CI = 0.87-1.11). Greater pain variability over 12-18 months was associated with more PA at follow-up in men (Ratio = 1.18, 95% CI = 1.01-1.38), but not in women (Ratio = 0.94, 95% CI = 0.86-1.03).

Conclusions: Greater pain severity and less pain variability are associated with less PA in older adults with OA. These associations are different for men and women. The observed sex differences in the various associations should be studied in more detail and need replication in future research.

Keywords: European multi-cohort study; Older adults; Osteoarthritis; Pain severity; Pain variability; Physical activity.

Conflict of interest statement

Ethics approval and consent to participate

All six cohort studies were approved by the Ethical Review Boards of the respective institutions (Germany: Ethical Committee of Ulm University; Italy: Ethics Committee ULSS7; the Netherlands: Medical Ethical Committee of the VU University medical center; Spain: Ethical Committee for Clinical Research of University Hospital La Paz of Madrid; Sweden: Ethics Board of Karolinska Institute; United Kingdom: The Hertfordshire Research Ethics Committee). All participants gave written informed consent prior to the start of the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no conflicts of interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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