title: Composite measures of multi-joint symptoms, but not of radiographic osteoarthritis, are associated with functional outcomes: the Johnston County Osteoarthritis Project.
abstract: OBJECTIVE
  To determine associations between multiple joint symptoms and radiographic osteoarthritis (rOA) and functional outcomes.
  
  
  METHODS
  Complete cross-sectional data for multi-joint symptoms and radiographs, Health Assessment Questionnaire (HAQ) scores, and gait speed were available for 1307 Johnston County Osteoarthritis Project participants (34% men, 32% African American, mean age 66 years). Factor analysis of symptom scores and radiographic grades for the lumbosacral spine, bilateral hands, knees, and hips provided composite scores. Regression models were used to determine associations between composite scores, HAQ, and gait speed, adjusting for age, body mass index, gender, and race.
  
  
  RESULTS
  Five rOA factors were identified: (1) IP/CMC factor (carpometacarpal [CMC] and all interphalangeal [IP] joints); (2) MCP factor (metacarpophalangeal joints 2-5); (3) Knee factor (tibiofemoral and patellofemoral joints); (4) Spine factor (L1/2 to L5/S1); and (5) Symptom factor. After adjustment, only the Symptom composite was significantly associated with HAQ and gait speed; a 1-standard deviation increase in Symptom score was associated with 9 times higher odds of having poorer function on the HAQ (odds ratio 9.32, 95% confidence interval [CI] 6.80, 12.77), and a clinically significant decline in gait speed (0.06 m/s, 95% CI -0.07, -0.05).
  
  
  CONCLUSIONS
  A novel Symptom composite score was associated with poorer functional outcomes.
  
  
  CONCLUSIONS
  Osteoarthritis (OA) commonly affects multiple joints and is the most common form of arthritis. Symptomatic assessments, which can be easily executed by rehabilitation practitioners, are more closely related to self-reported and performance-based functional status than are less accessible and more costly radiographs. Symptomatic assessments are likely to be more informative for understanding, treating, and potentially preventing functional limitations than radiographic assessments.
authors: Thurston Arthritis Research Center .
authors: Amanda E
authors: AE
authors: Nelson
authors: Emily
authors: E
authors: Elstad
authors: Robert F
authors: RF
authors: DeVellis
authors: Todd A
authors: TA
authors: Schwartz
authors: Yvonne M
authors: YM
authors: Golightly
authors: Jordan B
authors: JB
authors: Renner
authors: Philip G
authors: PG
authors: Conaghan
authors: Virginia B
authors: VB
authors: Kraus
authors: Joanne M
authors: JM
authors: Jordan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005163:Factor Analysis, Statistical; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000534:rehabilitation*; D011859:Radiography; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
references: J Rheumatol. 2007 Jan;34(1):172-80
references: 17216685
references: Ann Intern Med. 1992 Apr 1;116(7):598-9
references: 1543316
references: J Rheumatol. 1991 Oct;18(10):1581-6
references: 1765985
references: J Am Geriatr Soc. 2000 Sep;48(9):1136-41
references: 10983916
references: J Am Geriatr Soc. 2006 May;54(5):743-9
references: 16696738
references: Osteoarthritis Cartilage. 2011 Jun;19(6):634-8
references: 21310252
references: J Gerontol A Biol Sci Med Sci. 2009 Jul;64(7):763-70
references: 19228782
references: Arthritis Rheum. 2008 Jan;58(1):26-35
references: 18163497
references: J Rehabil Res Dev. 2005 Jul-Aug;42(4):535-46
references: 16320148
references: Disabil Rehabil. 2006 Dec 30;28(24):1543-9
references: 17178617
references: Ann Rheum Dis. 2011 Oct;70(10):1835-7
references: 21742640
references: Ann Rheum Dis. 2011 Jan;70(1):68-73
references: 20736393
references: Rheumatology (Oxford). 2005 Mar;44(3):337-41
references: 15536064
references: Rheumatology (Oxford). 2010 Sep;49(9):1753-5
references: 20525736
references: Ann Rheum Dis. 2009 Sep;68(9):1401-6
references: 18718988
references: Arthritis Care Res (Hoboken). 2010 Sep;62(9):1287-93
references: 20853470
references: Spine (Phila Pa 1976). 2010 Mar 1;35(5):531-6
references: 20147869
references: Arthritis Care Res. 1995 Dec;8(4):242-50
references: 8605262
references: Ann Rheum Dis. 1998 Nov;57(11):649-55
references: 9924205
references: Pain. 2007 Mar;128(1-2):69-77
references: 17055167
references: Arthritis Rheum. 2003 Oct;48(10):2836-44
references: 14558089
references: Arthritis Rheum. 1988 Feb;31(2):204-9
references: 3348824
references: J Rheumatol. 2000 Jun;27(6):1513-7
references: 10852280
references: J Rheumatol. 1997 Jul;24(7):1344-9
references: 9228135
references: Curr Opin Rheumatol. 2011 Sep;23(5):484-91
references: 21760511
references: Best Pract Res Clin Rheumatol. 2003 Feb;17(1):71-85
references: 12659822
references: Osteoarthritis Cartilage. 2001 Oct;9(7):606-11
references: 11597172
references: MMWR Morb Mortal Wkly Rep. 2009 May 1;58(16):421-6
references: 19407734
references: J Rheumatol. 2005 Jun;32(6):1147-9
references: 15977351
references: Arthritis Rheum. 2006 Aug 15;55(4):636-47
references: 16874787
references: Arthritis Rheum. 1983 Nov;26(11):1346-53
references: 6639693
references: Ann Rheum Dis. 1957 Dec;16(4):494-502
references: 13498604
references: Qual Life Res. 2008 May;17(4):529-39
references: 18365768
references: Arthritis Rheum. 2009 Aug 15;61(8):1054-61
references: 19644904
references: Arthritis Care Res (Hoboken). 2012 Jul;64(7):1028-35
references: 22392700
references: J Gerontol. 1994 Mar;49(2):M85-94
references: 8126356
references: Ann Rheum Dis. 1998 Apr;57(4):203-8
references: 9709175
references: J Gerontol A Biol Sci Med Sci. 1999 Jan;54(1):M3-6
references: 10026655
references: JAMA. 2011 Jan 5;305(1):50-8
references: 21205966
references: Arthritis Rheum. 2011 Jan;63(1):127-36
references: 20862681
references: Ann Rheum Dis. 2007 Jan;66(1):86-91
references: 16877532
references: Ann Rheum Dis. 2007 Dec;66(12):1622-6
references: 17504840
references: Osteoarthritis Cartilage. 2008 Apr;16(4):415-22
references: 18296075
references: Rheumatology (Oxford). 2007 Sep;46(9):1502-5
references: 17673479
references: BMJ. 2009 Aug 21;339:b2844
references: 19700505
references: Arthritis Res Ther. 2011;13(5):R176
references: 22027269