Background/Purpose: We analyzed the association between individual socio-economic status (SES) variables and clinical symptoms (function, pain and quality of life) in patients with symptomatic knee and/or hip osteoarthritis.

Methods: The prospective study used data from baseline to the 7-year follow-up visit of the Knee and Hip OsteoArthritis Long-term assessment (KHOALA) cohort. Function and pain were measured by Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC), and the quality of life by Medical Outcomes Study Short Form 36 (SF-36). Individual SES variables included educational level (5 categories), occupational status (7 categories), the monthly income per household (5 categories) and precarious status (EPICES score ≥30.17). We used a mixed model for repeated measures to analyze our outcomes measured annually at baseline to year 7 of follow-up.

Results: Eight hundred and seventy-eight patients were included. In univariate analyses, SES characteristics were significantly associated with WOMAC function, pain scores and SF-36 score (p< 0.0001 for educational level, occupational status, monthly income and precarious status), with a gradient against the less educated, the least qualified professional categories, the lowest monthly income and against precarious patients. In multivariate analyses adjusted on confounding factors (body mass index (BMI), axe, sex, year, education, occupational status, monthly income, precarious status, Kellgren-Lawrence score, groll score, metabolic equivalent of task (MET), evolutive time….), the WOMAC function score was associated with occupational status (p=0.0393) and precarious status (ß=1.81, 95% CI=0.72 to 2.90, p=0.00011). The WOMAC pain score was associated with occupational status (p=0.0128) and with educational level (p=0.0232). We didn’t observe a significant interaction between the time and the SES variables. Mental SF-36 score was associated with monthly income per household (p< 0.0001) and the precarious status (ß=-2.41, 95% CI=-3.83 to -0.99, p=0.0016). The physical SF-36 score was associated with educational level (p=0.0059) and precarious status (ß=-1.52, 95% CI=-2.15 to -0.88, p< 0.0001).

Conclusion: Our results suggest that individual SES characteristics have a significant impact on function and pain in hip and knee OA even taking into account various risk factors.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/individual-socio-economic-status-and-symptomatic-hip-and-knee-osteoarthritis-a-longitudinal-study-results-from-the-khoala-cohort/