Impact of multiple joint problems on daily living tasks in people in the community over age fifty-five.
OBJECTIVE
To establish the prevalence of multiple joint problems and their impact on everyday tasks.


METHODS
A random sample of the UK population was assessed using a postal questionnaire. Data on overall joint pain, swelling and stiffness, and activities of daily living were obtained from 16,222 individuals >55 years of age (86% response rate). Prevalence estimates of joint problems were established and the impact of multiple joint pathologies on common physical tasks was determined.


RESULTS
Single joint involvement was unusual (median joint involvement 4). Although the knee was the most frequently involved joint (220.30 per 1,000), isolated knee pathology accounted for only 1 in 11 patients with knee pain. Although single joint disorders increased the risk of experiencing functional difficulty, this risk was substantially increased with multiple joint problems: individuals with knee and feet problems were 14 times more likely to experience difficulty standing and walking than those without knee problems (odds ratio [OR] 14.50); knee and hip problems increased the risk >12 times (OR 12.43) whereas knee, back, feet, and hip involvement increased the risk 60 times (OR 62.41).


CONCLUSIONS
Multiple-site joint problems are much more common than single joint problems. Although individual joint problems have a considerable impact on a person's functional ability, this risk is substantially increased when other joints are involved. With the increasing burden associated with the aging population, it is essential that the management of joint pain be considered in light of the impact of multiple, rather than single, joint problems.
Keenan
Anne-Maree
AM
Academic Unit of Musculoskeletal Disease, University of Leeds, Chapel Allerton Hospital, Leeds, UK. a.keenan@leeds.ac.uk
Tennant
Alan
A
Fear
Jon
J
Emery
Paul
P
Conaghan
Philip G
PG
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D005260:Female; D005528:Foot / Q000473:pathology; D006615:Hip / Q000473:pathology; D006801:Humans; D007592:Joint Diseases / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D007717:Knee / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D010146:Pain / Q000150:complications / Q000209:etiology; D015995:Prevalence; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology