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Depression risk higher among knee OA patients with greater disease severity
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AMSTERDAM — Greater structural disease severity and decreased physical performance were linked to an increased risk for depression among patients with radiographic knee osteoarthritis, according to findings presented at the EULAR Annual Congress.
“Depression is a more frequently occurring comorbidity among patients with OA, and meta-analysis evidence indicates the prevalence of depressive symptoms in this population to be approximately 20% — more than double the general population estimates,” Alan M. Rathbun, PhD, MPH, of the University of Maryland School of Medicine, in Baltimore, said during a press conference. “Depression in knee OA is associated with lower quality of life, greater health care utilization expenditures, and higher mortality rate.”
To ascertain which components of OA disease severity contributed to depressive symptoms among patients with knee OA, Rathbun and colleagues evaluated a cohort of patients (n = 1,652) from the Osteoarthritis Initiative who exhibited radiographic disease, complete baseline covariate data and were below the screening threshold for probable depression. The researchers assessed OA disease severity at baseline and on three annual follow-up visits, examining patients for minimum joint space width, 20-metre gait speed and a pain subscale of the WOMAC Index.
Predictors of OA disease severity
Rathbun and colleagues evaluated OA disease severity predictors as a moving average at each time point then grouped into quintiles. The researchers inverted the joint space width and gait speed categories so that increasing quintile paralleled greater disease severity, with depression onset measured at four annual follow-up visits.
According to study results, depression onset was linked with increased severity for two of the three predictors. In order of increasing magnitude, the odds ratios comparing highest to lowest severity quintiles were 1.6 for pain (95% CI, 0.81-3.16), 2.08 for gait speed (95% CI, 1.16-3.75), and 2.25 for joint space width (95% CI, 1.27-3.99).
“The results imply that greater structural disease severity and decreased physical performance are associated with a statistically significant increased risk of experiencing depression,” Rathbun said. “Structural disease progression is irreversible and likely precedes pain and functional limitations over time. Moreover, pain and function can be treated with medical management, while there are no interventions except total knee replacement to modify structural disease severity; thus, greater structural disease severity may lead to worse psycho-social health and the onset of depression.” – by Bob Stott
Reference:
Rathbun AM. Abstract OP0003. Presented at: EULAR Annual Congress; June 13-16, 2018; Amsterdam.
Disclosure: Rathbun reports no relevant financial disclosures.