title: Impact of obesity and knee osteoarthritis on morbidity and mortality in older Americans.
abstract: BACKGROUND
  Obesity and knee osteoarthritis are among the most frequent chronic conditions affecting Americans aged 50 to 84 years.
  
  
  OBJECTIVE
  To estimate quality-adjusted life-years lost due to obesity and knee osteoarthritis and health benefits of reducing obesity prevalence to levels observed a decade ago.
  
  
  METHODS
  The U.S. Census and obesity data from national data sources were combined with estimated prevalence of symptomatic knee osteoarthritis to assign persons aged 50 to 84 years to 4 subpopulations: nonobese without knee osteoarthritis (reference group), nonobese with knee osteoarthritis, obese without knee osteoarthritis, and obese with knee osteoarthritis. The Osteoarthritis Policy Model, a computer simulation model of knee osteoarthritis and obesity, was used to estimate quality-adjusted life-year losses due to knee osteoarthritis and obesity in comparison with the reference group.
  
  
  METHODS
  United States.
  
  
  METHODS
  U.S. population aged 50 to 84 years.
  
  
  METHODS
  Quality-adjusted life-years lost owing to knee osteoarthritis and obesity.
  
  
  RESULTS
  Estimated total losses of per-person quality-adjusted life-years ranged from 1.857 in nonobese persons with knee osteoarthritis to 3.501 for persons affected by both conditions, resulting in a total of 86.0 million quality-adjusted life-years lost due to obesity, knee osteoarthritis, or both. Quality-adjusted life-years lost due to knee osteoarthritis and/or obesity represent 10% to 25% of the remaining quality-adjusted survival of persons aged 50 to 84 years. Hispanic and black women had disproportionately high losses. Model findings suggested that reversing obesity prevalence to levels seen 10 years ago would avert 178,071 cases of coronary heart disease, 889,872 cases of diabetes, and 111,206 total knee replacements. Such a reduction in obesity would increase the quantity of life by 6,318,030 years and improve life expectancy by 7,812,120 quality-adjusted years in U.S. adults aged 50 to 84 years.
  
  
  CONCLUSIONS
  Comorbidity incidences were derived from prevalence estimates on the basis of life expectancy of the general population, potentially resulting in conservative underestimates. Calibration analyses were conducted to ensure comparability of model-based projections and data from external sources.
  
  
  CONCLUSIONS
  The number of quality-adjusted life-years lost owing to knee osteoarthritis and obesity seems to be substantial, with black and Hispanic women experiencing disproportionate losses. Reducing mean body mass index to the levels observed a decade ago in this population would yield substantial health benefits.
  
  
  BACKGROUND
  The National Institutes of Health and the Arthritis Foundation.
authors.affiliation: Brigham and Women's Hospital, Boston University School of Public Health, Massachusetts General Hospital, USA. Elosina@partners.org
authors.forename: Elena
authors.initials: E
authors.lastname: Losina
authors.forename: Rochelle P
authors.initials: RP
authors.lastname: Walensky
authors.forename: William M
authors.initials: WM
authors.lastname: Reichmann
authors.forename: Holly L
authors.initials: HL
authors.lastname: Holt
authors.forename: Hanna
authors.initials: H
authors.lastname: Gerlovin
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Solomon
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Jordan
authors.forename: David J
authors.initials: DJ
authors.lastname: Hunter
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Suter
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Weinstein
authors.forename: A David
authors.initials: AD
authors.lastname: Paltiel
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Katz
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D003198:Computer Simulation; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D020370:Osteoarthritis, Knee / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D015995:Prevalence; D019057:Quality-Adjusted Life Years; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D001741:Black or African American