Rheumatology Advance Access originally published online on February 17, 2007
Rheumatology 2007 46(5):877-881; doi:10.1093/rheumatology/kem013
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Osteoarthritis as a public health problem: the impact of developing knee pain on physical function in adults living in the community: (KNEST 3)
Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire ST5 5BG, UK.
Correspondence to: Dr Clare Jinks, Lecturer in Health Services Research, Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire ST5 5BG, UK. E-mail: c.jinks{at}cphc.keele.ac.uk
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Objectives. To determine the effect of newly developed knee pain on general health and physical function of people
50 yrs living in the community.
Methods. Prospective cohort study of 3907 people aged 50+ registered with three general practices in North Staffordshire, in the UK. The main outcome measures were self-reported knee pain; general health and physical function as measured by the Short Form 36 (SF-36).
Results. Of those with no knee pain at baseline, 24% (n = 501) reported it at follow-up. There was a steep decline in physical function in this group (mean fall in SF-36 score at follow-up 10.3 points) compared with the 1558 persons who had no knee pain at baseline or follow-up (mean fall 3.3). Those with knee pain at baseline whose pain had resolved at 3-yr follow-up (n = 409) showed only minor improvements in physical functioning scores at follow-up (mean improvement 1.3).
Conclusions. The onset of knee pain is associated with a substantial and persistent reduction of physical function in older adults living in the community. Since knee pain is common, and reduced physical function in mid to older ages is a strong predictor of future disability and dependency, effective prevention or early treatment of knee pain at these ages is likely to have a major influence on healthy ageing in the population.
KEY WORDS: Public health, Knee pain, Osteoarthritis, SF-36, Disability, Survey, Knee Pain Screening Tool (KNEST)
Submitted 27 October 2006;
revised version accepted 3 January 2007.
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