Patients with arthritis at higher risk for poor nutrition regardless of function
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Key takeaways:
- Older adults with arthritis are at higher risk for poor nutrition, with or without functional impairment.
- Multifactorial links between arthritis and nutrition call for “intersectional perspective,” the researchers wrote.
Older adults with arthritis demonstrate poorer nutritional risk scores, and increased risks for poor nutrition, whether they have functional impairment or not, vs. those without arthritis, according to data published in Scientific Reports.
“While the relationship between arthritis and functional impairment is established, the contribution of different types of arthritis, such as osteoarthritis, and other external factors to the development of functional impairment, and further to the development of nutritional risk, is less understood,” Roxanne Bennett, MSc, RD, of the Concordia University School of Health, in Montreal, and colleagues wrote. “There is a paucity of data on the relationship between arthritis, nutrition risk and the role of functional impairment within that relationship.”
To examine the interaction between arthritis, functional impairment and nutritional risk, Bennett and colleagues analyzed data from the Canadian Longitudinal Study on Aging, a nationally representative, retrospective cohort study. The analysis included 41,153 Canadians aged 45 to 85 years, 35.2% of whom self-reported having some form of arthritis, including knee OA (n = 6,019), hip OA (n = 3,426), hand OA (n = 5,261), rheumatoid arthritis (n = 1,510) or any other form (n = 4,901).
Risk factors for poor nutrition, including recent weight changes, meal skipping frequency, appetite level, and swallowing difficulties were assessed using a 48-point tool called the Seniors in the Community Risk Evaluation for Eating and Nutrition II-Abbreviated. Functional impairment was evaluated using the Older Americans’ Resources and Services Multidimensional Functional Assessment Questionnaire. Multiple linear regression models, adjusted for demographic characteristics and other factors, were used to conduct the analysis.
According to the researchers, patients with arthritis demonstrated worse nutritional risk scores (beta = –0.35; 95% CI, –0.48 to –0.22) and greater chances of high nutritional risk, defined as a total score of 38 or less (OR = 1.11; 95% CI, 1.06-1.17). Compared with individuals without arthritis, those with arthritis had a greater likelihood of high nutritional risk consistently across subsets of patients with functional impairment (OR = 1.31; 95% CI, 1.11-1.53) and those with no functional impairment (OR = 1.1; 95% CI, 1.04-1.16).
In addition, patients with RA had worse nutritional risk scores (beta = –0.99; 95% CI, –1.36 to –0.62). Among participants with arthritis but no functional impairment, those with RA had the highest chance of high nutritional risk (OR = 1.29; 95% CI, 1.13-1.47).
“The results of this study highlight the presence of an association between arthritis with poorer nutritional risk scores and higher nutritional risk in a nationally representative sample of Canadian adults between the ages of 45 and 85 years,” Bennett and colleagues wrote. “There is increasing evidence indicating that the relationship between nutrition and arthritis is multifactorial, likely caused by complex interactions between physical, psychological, social, financial, and environmental factors.
“The overlap of these characteristics warrants an intersectional perspective, especially as there is evidence separately linking each of these factors to functional status, disease activity, and dietary behaviors,” they added. “More research is necessary to understand the relationship between arthritis and nutrition in specific groups to inform adapted preventative interventions and improve clinical practices.”
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