title: The onset of generalized osteoarthritis in older women: a qualitative approach.
abstract: OBJECTIVE
  This qualitative study aims to investigate which factors are possibly associated with the onset of generalized osteoarthritis (OA) in older women.
  
  
  METHODS
  The study population was recruited from participants of a group course, "Coping With Osteoarthritis of the Hip or Knee." Twenty-three women with generalized OA were identified, 20 of whom participated in a semistructured interview at home. All data were self-reported by the subjects.
  
  
  RESULTS
  Hereditary factors were present in 17 women. Metabolic factors (such as impairments in carbohydrate and lipid metabolism, diabetes, etc.) were not prevalent. Twelve women thought that certain diets influenced their pain symptoms. Five women spontaneously mentioned their health status during the Second World War as a cause of their OA. Four considered too much stress as being a cause, and in 13 women symptoms started after a period of stressful life events or depression.
  
  
  CONCLUSIONS
  According to the respondents, depression, stress, and diets are associated with the onset and worsening of their generalized OA. Heredity and a low health status at a vulnerable age may also be important. These findings could generate new hypotheses that can be tested in future quantitative studies.
authors.affiliation: Division of Public Health, TNO Prevention and Health, Leiden, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Okma-Keulen
authors.forename: M
authors.initials: M
authors.lastname: Hopman-Rock
mesh_terms: D017668:Age of Onset; D000368:Aged; D019902:Chondrocytes / Q000378:metabolism; D002910:Chronology as Topic; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007596:Joints / Q000503:physiopathology; D008019:Life Style; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010003:Osteoarthritis / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism / Q000523:psychology; D012307:Risk Factors