Background/Purpose: To compare the prevalence of meeting current public health physical activity (PA) guidelines by arthritis and knee/hip joint pain status, and to examine the relationship between arthritis, joint pain and accelerometer-measured PA in US older adults.

Methods: Data are a sample of 1680 men and women from the 2003-2004 NHANES aged ≥50 years who had 4+ valid days (≥ 10 hrs∙d^-1) of hip-worn accelerometer wear-time. PA was examined 2 ways: 1) adherence to PA guidelines of accumulated 10-minute bouts of moderate/vigorous physical activity (MVPA) (inactive: no bouts; insufficient <150 min∙wk^-1; recommended: ≥150 min∙wk^-1) using average daily minutes; and 2) average counts per minute (CPM) during wear-time and min∙d^-1spent in sedentary, light, lifestyle, and MVPA. Participants self-reported doctor-diagnosed arthritis and knee and/or hip joint pain, and were categorized as follows: 1) no arthritis or joint pain (NEITHER); 2) arthritis only (ARTH); 3) joint pain only (JP); and 4) arthritis and joint pain (BOTH). Regression analyses adjusted for age, education, race, occupation, BMI, smoking status, self-rated health, self-reported functional limitations, arthritis-attributable limitations, and current pain medication use. All analyses were stratified by gender and accounted for NHANES PA monitor sampling weights.

Results: Age-adjusted prevalence of arthritis and joint pain (knee and/or hip) was 44% and 47%, respectively. These conditions co-occurred in 33% of participants (BOTH); 42% had NEITHER condition, 11% had ARTH only, and 14% had JP only. Having BOTH was more common among women (40%) than in men (24%).

The proportions of women meeting PA guidelines in the NEITHER (5%) and JP (6%) groups were similar. Women with ARTH and BOTH had the lowest proportion of recommended PA (<1%; 2%). Only 7% of men without either condition (NEITHER) achieved recommended PA, which was similar to men with ARTH (7%); however, the proportion meeting recommended PA was substantially lower in men with JP or BOTH (2%; 3%).

Regression models adjusted for demographics showed that women with ARTH, JP, or BOTH had lower CPM and lower levels of PA by various measures, which remained significant, though attenuated, after further adjustment for health conditions and functional limitations. Relative to the NEITHER group, women with ARTH had fewer CPM (B=-23.6, p=0.027) and fewer min∙d^-1 of MVPA (B=-3.2, p≤0.001), and women with BOTH had 2.4 fewer min∙d^-1of MVPA (p=0.013). Among men, only those with BOTH had fewer min∙d^-1of MVPA compared to men in the NEITHER group (B=-12.2, p=0.004); however further adjustment for health conditions and functional limitations yielded unexpectedly higher CPM, fewer sedentary min∙d^-1, and greater time in lifestyle-intensity activity in men with ARTH and BOTH compared to men in the NEITHER group.

Conclusion: Adherence to PA guidelines was low across all groups. Our data suggests gender differences in the relationship between arthritis, joint pain and PA. Women with ARTH and BOTH were generally less active, whereas men with ARTH and BOTH were more active than those with NEITHER. Continued PA promotion and pain management should be intensively targeted to US older adults with arthritis and joint pain.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-of-arthritis-and-joint-pain-with-accelerometer-measured-physical-activity-in-adults-aged-50-and-older-in-the-united-states-findings-from-the-national-health-and-nutrition-examination-surv/