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Abstract Number: 1134

Some Is Better Than None: Minimum Physical Activity Threshold to Prevent Disability in Older Adults with Lower Extremity Joint Symptoms

Dorothy D. Dunlop1, Jing Song1, Jennifer M. Hootman2, Julia (Jungwha) Lee3, Michael C. Nevitt4, Leena Sharma5, Pamela Semanik6, Charles B. Eaton7, C. Kent Kwoh8, Marc C. Hochberg9, Rebecca D. Jackson10 and Rowland W. Chang11, 1Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL, 2Arthritis Program, Centers for Disease Control and Prevention, Atlanta, GA, 3Department of Preventive Medicine, Biostatistics Collaboration Center, Northwestern University Feinberg School of Medicine, Chicago, IL, 4Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, 5Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL, 6College of Nursing, Rush University, Chicago, IL, 7Family Medicine and Community Health( Epidemiology), Alpert Medical School of Brown University, Pawtucket, RI, 8Medicine, Division of Rheumatology, University of Arizona School of Medicine, University of Arizona Arthritis Center, Tucson, AZ, 9University of Maryland School of Medicine, Baltimore, MD, 10Ohio State University, Columbus, OH, 11Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Disability, Knee, Osteoarthritis and physical activity

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Session Information

Date: Monday, October 22, 2018

Title: Epidemiology and Public Health Poster II: Gout, Ankylosing Spondylitis, Osteoarthritis, Osteoporosis, Pain, and Function

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: This study evaluated physical activity and sedentary times to identify an evidence-based threshold related to remaining free of disability over 4 years among adults with lower extremity joint symptoms.

Methods: Remaining free of disability over 4 years (i.e., no disability onset) was assessed from self-report of no limitations in activities of daily living (ADL-disability free) and objective gait speed ≥1 meter/second (mobility-disability free). Adults with symptomatic lower extremity (hip, knee, ankle, foot) joint pain/aching/stiffness who participated in an accelerometer substudy of the Osteoarthritis Initiative (OAI) included n=1564 ADL-disability free (n=1460) or mobility-disability free (n=1370) persons at baseline (OAI 48-month clinic visit). Optimal thresholds predicting 4-year disability-free status were assessed by maximum area under the receiver operating characteristic curve (AUC) and classification tree analysis.

Results: Over four years 84% (1222/1460) participants remained free of ADL-disability and 89% (1223/1370) remained free of mobility-disability.  Figure 1 shows total MV activity per week was the strongest predictor of all Table 1 candidate measures based on the greatest AUC of remaining free of ADL-disability (AUC=0.61) and free of mobility-disability (AUC=0.80). Classification tree analyses selected total MV>55 minutes/week over all possible activity/sedentary candidate thresholds as the best discriminator between remaining free of versus developing ADL-disability and mobility-disability. Observed disability onset rates over four years were almost double (23% versus 12%) for developing ADL-disability and 8 times greater (24% versus 3%) for mobility-disability among persons below compared to those above this threshold. Meeting the 55 total MV minute/week threshold significantly increased the odds for remaining free of ADL-disability (odds ratio [OR]: 2.0, 95% CI: 1.5 to 2.7) and free of mobility disability (OR 8.6, 95% CI: 5.7 to 13.1).  Thresholds were consistent across sex, BMI, age, and radiographic knee OA status.

Conclusion: Meeting an evidence-based threshold of at least 55 total MV minutes/week increased the likelihood of remaining free of both ADL-disability and mobility-disability over 4 years among adults with lower extremity joint symptoms.  This evidence-based threshold supports future disability-free status and may help motivate sedentary adults with joint conditions to begin their path towards attaining the federal recommendation which promotes a wide range of health benefits.


Disclosure: D. D. Dunlop, None; J. Song, None; J. M. Hootman, None; J. Lee, None; M. C. Nevitt, None; L. Sharma, None; P. Semanik, None; C. B. Eaton, None; C. K. Kwoh, None; M. C. Hochberg, None; R. D. Jackson, None; R. W. Chang, None.

To cite this abstract in AMA style:

Dunlop DD, Song J, Hootman JM, Lee J, Nevitt MC, Sharma L, Semanik P, Eaton CB, Kwoh CK, Hochberg MC, Jackson RD, Chang RW. Some Is Better Than None: Minimum Physical Activity Threshold to Prevent Disability in Older Adults with Lower Extremity Joint Symptoms [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/some-is-better-than-none-minimum-physical-activity-threshold-to-prevent-disability-in-older-adults-with-lower-extremity-joint-symptoms/. Accessed .
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