title: Prospective study of self-reported pain, radiographic osteoarthritis, sarcopenia progression, and falls risk in community-dwelling older adults.
abstract: OBJECTIVE
  To examine the potential role of self-reported joint pain, stiffness, and dysfunction, and radiographic osteoarthritis (ROA), in sarcopenia progression and falls risk in older adults.
  
  
  METHODS
  Seven hundred nine older adults (50% women, mean ± SD age 62 ± 7 years) were examined at baseline and followup (mean ± SD 2.6 ± 0.4 years). ROA was assessed using the Altman atlas, and pain at 7 anatomic sites was self-reported. Dual x-ray absorptiometry assessed leg lean mass, dynamometry assessed knee extension and whole leg strength, leg muscle quality (LMQ) was calculated as whole leg strength relative to leg lean mass, and the Physiological Profile Assessment assessed falls risk.
  
  
  RESULTS
  In women only, baseline knee pain predicted a greater decline in knee extension strength, whole leg strength, and LMQ, and a greater increase in falls risk. Severe knee pain, stiffness, and dysfunction predicted greater declines in knee extension strength and increases in falls risk (all P < 0.05). Hip pain also predicted a greater decline in knee extension strength (-1.53 kg; 95% confidence interval [95% CI] -2.95, -0.11). No associations were observed between pain and sarcopenia indicators in men. Somewhat surprisingly, higher baseline total knee ROA score predicted a greater increase in mean leg lean mass (0.05 kg; 95% CI 0.02, 0.08) in both sexes. A path analysis demonstrated that knee ROA may contribute to declines in LMQ in women, through increases in pain, stiffness, and dysfunction.
  
  
  CONCLUSIONS
  Knee and hip pain may directly contribute to the progression of sarcopenia and increased falls risk in older women.
authors: Menzies Research Institute, University of Tasmania, Hobart, Australia. d.scott@cqu.edu.au
authors: David
authors: D
authors: Scott
authors: Leigh
authors: L
authors: Blizzard
authors: James
authors: J
authors: Fell
authors: Graeme
authors: G
authors: Jones
mesh_terms: D015502:Absorptiometry, Photon; D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000375:Aging; D018771:Arthralgia / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D010147:Pain Measurement; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055948:Sarcopenia / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D057566:Self Report; D012720:Severity of Illness Index; D013648:Tasmania; D013997:Time Factors