Nearly one-quarter of US adults have arthritis; 43% of those report activity limitations
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An estimated 58.5 million adults in the United States — nearly one-quarter of the country’s adult population — had arthritis, while 25.7 million demonstrated arthritis-related activity limitations, during 2016 to 2018, according to data.
The figures point to a continuously rising trend, following 2013 to 2015 estimates that reached 54.4 million and 23.7 million, respectively, the researchers wrote.
“This study is the most recent in a series of reports examining the prevalence of arthritis and arthritis-attributable activity limitations among U.S. adults,” Kristina A. Theis, PhD, of the CDC’s National Center for Chronic Disease Prevention and Health Promotion, told Healio Rheumatology. “We found that the number of U.S. adults with arthritis continues to increase along a 15-year trend; it increased by 4.1 million, from 54.4 million in 2013 to 2015 to 58.5 million in 2016 to 2018. A similar increasing trend was observed for the number of U.S. adults whose activities were limited due to arthritis.”
“However, this trend is increasing faster than projected,” she added. “It increased over the last surveillance period by 2 million, from 23.7 million to 25.7 million. Our analysis shows that there are groups of people — for example, adults with fewer economic opportunities, adults with poorer overall health, including mental health, and adults with physical limitations — with disproportionate unmet need for existing evidence-based interventions to help manage arthritis and delay or prevent activity limitations due to arthritis.”
To update the national prevalence estimates for arthritis and arthritis-attributable activity limitation (AAAL) in U.S. adults, researchers from the CDC analyzed National Health Interview Survey (NHIS) data from 2016 to 2018. According to the researchers, the NHIS is an ongoing, nationally representative, in-person health survey of noninstitutionalized civilians in the United States. Adult sample sizes for 2016, 2017 and 2018 were 33,028, 26,742 and 25,417, respectively.
Participants were asked whether they had been told by a doctor or other health care professional that they have arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia. Respondents were also asked if they were “limited in any way” in any of their usual activities due to arthritis or joint symptoms.
The researchers calculated annualized unadjusted and age-standardized prevalence estimates for arthritis and AAAL, both overall and based on selected sociodemographic, health and function characteristics. In addition, they applied sampling weights to account for the complex survey design, to generate nationally representative estimates, and to adjust for nonresponse. To assess change over time, Theis and colleagues performed a secondary analysis using the same methods to estimate annualized absolute prevalence figures for 2003-2005, 2007-2009, 2010-2012 and 2013-2015.
According to the researchers, who published their findings in Morbidity and Mortality Weekly Report, 23.7% of the United States adult population — or an estimated 58.5 million people — had arthritis during 2016 to 2018. The prevalence of both arthritis and AAAL was highest among adults with physical limitations, few economic opportunities and poor overall health.
Arthritis was reported by 50.4% of respondents aged 65 years or older, 52.3% of those who were unable to work or disabled, 51.2% of adults with fair or poor self-rated health, 52.2% of adults who reported joint symptoms in the past 30 days, 54.8% of those with activities of daily living disability, and 55.9% of those with instrumental activities of daily living disability.
“Clinicians are ideally positioned to address the findings of this study in two ways,” Theis said. “First, people with arthritis want and need for their health care providers to advise them regarding arthritis-appropriate physical activities and other non-pharmaceutical interventions to manage their arthritis symptoms. Our report provides resources to support clinicians in starting conversations with patients about their highest priority needs — eg, self-management education, physical activity, workplace accommodations, mental health — to match patients to the intervention that is best suited to address those needs.”
According to Theis, these resources include links to the Job Accommodation Network, the Physical Activity Guidelines for Americans, mental health screening tools, and the CDC Arthritis Program website, which includes detailed information on evidence-based self-management education and physical activity programs.
“Second, health care providers are a vital link to the community care delivery systems of these interventions,” she added. “When health care providers recommend evidence-based, community-delivered intervention programs to patients, patients are much more likely to attend and participate in these programs. A staged approach may be best. For example, learning self-management skills and then moving on to a physical activity intervention might be the best way to start and sustain physical activity to get the desired benefits.”
Perspective
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As many of us working in the field of rheumatology are aware, arthritis is one of the leading causes of disability among U.S. adults. The related cost of medical care expenditures was responsible for over $300 billion in 2013 as referenced in the study by Theis and colleagues.
As the national prevalence of arthritis and arthritis-attributable activity limitations continue to increase, with a 49% projected increase over the next 20 years, it is clear that there is a need for more widespread distribution of existing, evidence-based, community-delivered interventions. These interventions, along with clinical support and an increased attention to the socioeconomic influences of health care can help reduce widespread arthritis prevalence and its adverse effects.
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