title: Osteoarthritis and mortality: A prospective cohort study and systematic review with meta-analysis.
abstract: Osteoarthritis (OA) is a leading cause of disability, but the relationship with premature mortality remains uncertain. We aimed to investigate the relationship between OA and mortality from any cause and from cardiovascular disease (CVD).
  
  
  
  Electronic literature databases searches were conducted to identify prospective studies comparing mortality in a sample of people with and without OA. Risk of all-cause and CVD mortality were summarized using adjusted hazard ratios (HRs) for joint specific (hand, hip, and knee) and joint non-specific OA. New data from the Progetto Veneto Anziani (PRO.V.A.) study were also included.
  
  
  
  From the PRO.V.A. study (N = 2927), there was no significant increase in mortality risk for participants with any joint OA (N = 1858) compared to non-OA (all-cause, HR = 0.95, 95% CI: 0.77-1.15 and CVD, HR = 1.12, 95% CI: 0.82-1.54). On meta-analysis, seven studies (OA = 10,018/non-OA = 18,541), with a median 12-year follow-up, reported no increased risk of any-cause mortality in those with OA (HR = 1.10, 95% CI: 0.97-1.25). After removing data on hand OA, a significant association between OA and mortality was observed (HR = 1.18, 95% CI: 1.08-1.28). There was a significant higher risk of overall mortality for (1) studies conducted in Europe, (2) patients with multi-joint OA; and (3) a radiological diagnosis of OA. OA was associated with significantly higher CVD mortality (HR = 1.21, 95% CI: 1.10-1.34).
  
  
  
  People with OA are at increased risk of death due to CVD. The relationship with overall mortality is less clear and may be moderated by the presence of hand OA.
authors.affiliation: Geriatrics Section, Department of Medicine (DIMED), University of Padova, Padova, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Veronese
authors.affiliation: Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cereda
authors.affiliation: Aging Branch, Institute of Neuroscience, National Research Council-CNR, Padova, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Maggi
authors.affiliation: Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Luchini
authors.affiliation: Department of Neurosciences, University of Padova, Padova, Italy; Local Health Unit 17, Mental Health Department, Padova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Solmi
authors.affiliation: Faculty of Medicine and Health Sciences, School of Health Sciences, University of East Anglia, Norwich, UK.
authors.forename: Toby
authors.initials: T
authors.lastname: Smith
authors.affiliation: Geriatric Research Unit, Agaplesion Bethesda Clinic, University of Ulm, Ulm, Germany; Geriatric Centre Ulm/Alb-Donau, Ulm University, Ulm, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Denkinger
authors.affiliation: Faculty of Health and Social Care Sciences, St Georges University of London, London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Hurley
authors.affiliation: Faculty of Education and Health, University of Greenwich, London, UK.
authors.forename: Trevor
authors.initials: T
authors.lastname: Thompson
authors.affiliation: Geriatrics Section, Department of Medicine (DIMED), University of Padova, Padova, Italy; Aging Branch, Institute of Neuroscience, National Research Council-CNR, Padova, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
authors.affiliation: Geriatrics Section, Department of Medicine (DIMED), University of Padova, Padova, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sergi
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK. Electronic address: brendon.stubbs@kcl.ac.uk.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality*; D015897:Comorbidity; D006801:Humans; D010003:Osteoarthritis / Q000401:mortality*; D011446:Prospective Studies; D012307:Risk Factors
keywords: Cardiovascular disease; Mortality; Osteoarthritis