title: Relationships between physical performance and knee and hip osteoarthritis: findings from the European Project on Osteoarthritis (EPOSA).
abstract: BACKGROUND
  poor physical performance (PP) is known to be associated with disability, lower quality of life and higher mortality rates. Knee and hip osteoarthritis (OA) might be expected to contribute to poor PP, through joint pain and restricted range of movement. Both clinical and self-reported OA are often used for large-scale community and epidemiological studies.
  
  
  OBJECTIVE
  to examine the relationships between hip and knee OA and PP in a large data set comprising cohorts from six European countries.
  
  
  METHODS
  a total of 2,942 men and women aged 65-85 years from the Germany, Italy, Netherlands, Spain, Sweden and the UK were recruited. Assessment included an interview and clinical assessment for OA. PP was determined from walking speed, chair rises and balance (range 0-12); low PP was defined as a score of ≤9.
  
  
  RESULTS
  the mean (SD) age was 74.2 (5.1) years. Rates of self-reported OA were much higher than clinical OA. Advanced age, female gender, lower educational attainment, abstinence from alcohol and higher body mass index were independently associated with low PP. Clinical knee OA, hip OA or both were associated with a higher risk of low PP; OR (95% CI) 2.93 (2.36, 3.64), 3.79 (2.49, 5.76) and 7.22 (3.63, 14.38), respectively, with relationships robust to adjustment for the confounders above as well as pain.
  
  
  CONCLUSIONS
  lower limb OA at the hip and knee is associated with low PP, and for clinical diagnosis relationships are robust to adjustment for pain. Those at highest risk have clinical OA at both sites.
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Edwards
authors.affiliation: VU University Medical Centre, Amsterdam, Netherlands.
authors.forename: Suzan
authors.initials: S
authors.lastname: van der Pas
authors.affiliation: Bethesda Geriatrische Klinik, Ulm, Germany.
authors.forename: Michael Dieter
authors.initials: MD
authors.lastname: Denkinger
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Camille
authors.initials: C
authors.lastname: Parsons
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Jameson
authors.affiliation: VU University Medical Centre, Amsterdam, Netherlands.
authors.forename: Laura
authors.initials: L
authors.lastname: Schaap
authors.affiliation: Department of Medical and Surgical Sciences, University of Padova, Padova, Italy.
authors.forename: Sabina
authors.initials: S
authors.lastname: Zambon
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad Autonoma de Madrid, Madrid, Spain.
authors.forename: Maria-Victoria
authors.initials: MV
authors.lastname: Castell
authors.affiliation: Bethesda Geriatrische Klinik, Ulm, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Herbolsheimer
authors.affiliation: Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Nasell
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad Autonoma de Madrid, Madrid, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Sanchez-Martinez
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad Autonoma de Madrid, Madrid, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Otero
authors.affiliation: Bethesda Geriatrische Klinik, Ulm, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Nikolaus
authors.affiliation: VU University Medical Centre, Amsterdam, Netherlands.
authors.forename: Natasja M
authors.initials: NM
authors.lastname: van Schoor
authors.affiliation: Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Pedersen
authors.affiliation: Department of Medical and Surgical Sciences, University of Padova, Padova, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Maggi
authors.affiliation: VU University Medical Centre, Amsterdam, Netherlands.
authors.forename: Dorly J H
authors.initials: DJ
authors.lastname: Deeg
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Elaine
authors.initials: E
authors.lastname: Dennison
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000453:epidemiology / Q000503:physiopathology; D016009:Chi-Square Distribution; D005060:Europe / Q000453:epidemiology; D005260:Female; D005684:Gait; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D010808:Physical Examination; D004856:Postural Balance; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D057566:Self Report; D016138:Walking
keywords: European; older people; osteoarthritis; physical performance; prevalence