Background/Purpose: Cardiovascular and lung disorder morbidities are more common in people with inflammatory arthritis (IA) than in the general population.  However, little is known about the impact of these morbidities on daily functioning including physical activity.  The aim of this study was to investigate the levels of physical activity in people with and without these morbidities.

Methods:    This study was conducted in a large population-based study in the UK (UK Biobank), including people aged 40 to 70.   Age, gender, and smoking status were recorded at inclusion.  Inflammatory arthritis (rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS)) and morbidity data including cardiovascular diseases (heart attack, angina, stroke) and lung disorders (emphysema, bronchitis, and asthma) was identified on the basis of self-report and participants were categorised as follows:  no IA and no morbidity (noIA-noM), no IA and morbidity (noIA-M), IA and no morbidity (IA-noM) or IA and morbidity (IA-M).   Participants completed the International Physical Activity Questionnaire and were classified as doing “low physical activity (lpa)”, “moderate physical activity (mpa)” or “vigorous physical activity (vpa)”.  Multinominal logistic regression analysis was applied to assess the association between health status group (noIA-noM=base case) and physical activity group (lpa=reference), adjusted for gender, age and smoking, and presented as relative risk ratios (adjRRR, (95%CI)).  Adjusted probabilities for each activity level are presented in figure.

Results: This study included 400,261 (81.5%) people with noIA-noM, 83,246 (17.0%) people with noIA-M, 5,800 (1.2%) people with IA-noM, and 1,790 (0.36%) people with IA-M.  Percentage female gender was, respectively, 55%, 51%, 63%; and 63% and mean (SD) age ranged from 56 (8) to 59 (7) years.  Within each group, the percentage of participants doing lpa, mpa or vpa was, respectively:  lpa (24.9%, 29.3%, 34.9%, 42.9%); mpa (38.4%, 36.9%, 35.6%, 32.0%) or vpa (36.7%, 33.8%, 29.5%, 25.1%).  The expected risk for people with a cardiovascular/lung disorder morbidity and/or IA doing moderate or vigorous activity was lower than those without these diseases.  Furthermore, people with IA, but no morbidity, were less likely to do mpa or vpa than people without IA, but having these morbidities.  adjRRRs (95%CI) for noIA-M, IA-noM and IA-M were respectively:  for mpa (0.82 (0.80-0.83); 0.66 (0.62-0.71); 0.49 (0.44-0.55)) and even lower for vpa (0.78 (0.77-0.79); 0.59 (0.55-0.63); 0.42 (0.37-0.47)).  Adjusted probabilities are shown in figure.

Conclusion:  In this large population-based study we observed that people with both IA and morbidities were less active compared to those without morbidities or those with no IA and morbidities.  It is therefore important to evaluate morbidities in clinical studies when investigating functional ability.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-impact-of-cardiovascular-and-lung-disorder-morbidities-on-physical-activity-in-people-with-inflammatory-arthritis-compared-to-the-general-population-in-the-uk/