Health-related quality of life in subjects with low back pain and knee pain in a population-based cohort study of Japanese men: the Research on Osteoarthritis Against Disability study.

STUDY DESIGN: Cross-sectional surveys of health-related quality of life (QOL) in subjects with low back pain and knee pain using a population-based cohort. OBJECTIVE: The purpose of the present study was to clarify the impact of low back pain and knee pain on QOL in men. In addition, we analyzed the impacts of vertebral fracture (VFx), lumbar spondylosis, and knee osteoarthritis (OA) on the magnitude of QOL loss in men with low back pain and knee pain. SUMMARY OF BACKGROUND DATA: Low back pain and knee pain are major public health issues causing disability among the elderly men, but there were no population-based studies to compare the impact of low back pain on QOL with that of knee pain in Japanese men. METHODS: From 3040 participants in the Research on Osteoarthritis Against Disability study, data from 767 men older than 40 years who completed questionnaires (mean age = 69.7 years) were examined. To carry out the QOL assessment, the Medical Outcomes Study Short Form 8 (SF-8) and EuroQol (EQ-5D) were used. We examined the association of low back pain and knee pain with QOL. Furthermore, we also examined the presence of VFx and the severity of lumbar spondylosis and knee OA with the magnitude of QOL loss in men with low back pain and knee pain, respectively. RESULTS: The impact of low back pain on QOL was larger than that of knee pain. In men with low back pain, there were few associations between Kellgren-Lawrence grade and QOL, whereas VFx was associated with physical QOL. For men with knee pain, Kellgren-Lawrence grade equal to 4 knee OA was associated with QOL. CONCLUSION: This study revealed that low back pain has a larger impact than knee pain on QOL. Furthermore, low back pain with VFx is strongly associated with physical QOL loss.

Impact of knee and low back pain on health-related quality of life in Japanese women: the Research on Osteoarthritis Against Disability (ROAD).

Although knee and low back pain are major public health issues, little information is available on their impact on the quality of life (QOL). We have investigated the impact of knee and low back pain on the QOL in Japanese women by assessing the associations between knee pain and low back pain and various QOL domains using measures such as the Medical Outcomes Study Short Form-8, EuroQOL, and the Western Ontario and McMaster Universities Osteoarthritis Index. From the 3,040 Japanese women participating in the Research on Osteoarthritis Against Disability (ROAD) study, we analyzed data on 1,369 women >40 years old (mean age 68.4 years). We further examined the associations of Kellgren-Lawrence (KL) grade at the knee and lumbar spine and the presence of vertebral fracture (VFx) with the magnitude of QOL loss in women with knee pain and low back pain, respectively. Knee pain and low back pain were found to be significantly associated with lower QOL scores among the women comprising the study cohort. In women with knee pain KL = 4, knee osteoarthritis was strongly associated with the magnitude of QOL loss. For women with low back pain, no significant associations were found between KL grade and magnitude of QOL loss, while there was a moderate association between the latter and VFx.

Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study.

Musculoskeletal diseases, especially osteoarthritis (OA) and osteoporosis (OP), impair activities of daily life (ADL) and quality of life (QOL) in the elderly. Although preventive strategies for these diseases are urgently required in an aging society, epidemiological data on these diseases are scant. To clarify the prevalence of knee osteoarthritis (KOA), lumbar spondylosis (LS), and osteoporosis (OP) in Japan, and estimate the number of people with these diseases, we started a large-scale population-based cohort study entitled research on osteoarthritis/osteoporosis against disability (ROAD) in 2005. This study involved the collection of clinical information from three cohorts composed of participants located in urban, mountainous, and coastal areas. KOA and LS were radiographically defined as a grade of > or =2 by the Kellgren-Lawrence scale; OP was defined by the criteria of the Japanese Society for Bone and Mineral Research. The 3,040 participants in total were divided into six groups based on their age: < or =39, 40-49, 50-59, 60-69, 70-79, and > or =80 years. The prevalence of KOA in the age groups < or =39, 40-49, 50-59, 60-69, 70-79, and > or =80 years 0, 9.1, 24.3, 35.2, 48.2, and 51.6%, respectively, in men, and the prevalence in women of the same age groups was 3.2, 11.4, 30.3, 57.1, 71.9, and 80.7%, respectively. With respect to the age groups, the prevalence of LS was 14.3, 45.5, 72.9, 74.6, 85.3, and 90.1% in men, and 9.7, 28.6, 41.7, 55.4, 75.1, and 78.2% in women, respectively. Data of the prevalence of OP at the lumbar spine and femoral neck were also obtained. The estimated number of patients with KOA, LS, and L2-L4 and femoral neck OP in Japan was approximately 25, 38, 6.4, and 11 million, respectively. In summary, we estimated the prevalence of OA and OP, and the number of people affected with these diseases in Japan. The ROAD study will elucidate epidemiological evidence concerning determinants of bone and joint disease.

Association of occupational activity with radiographic knee osteoarthritis and lumbar spondylosis in elderly patients of population-based cohorts: a large-scale population-based study.

OBJECTIVE: To investigate the risk of radiographic knee osteoarthritis (OA) and lumbar spondylosis associated with occupational activity in elderly Japanese subjects using the large-scale population-based cohort of the Research on Osteoarthritis Against Disability (ROAD) study. METHODS: From the baseline survey of the ROAD study, 1,471 participants age > or =50 years (531 men and 940 women) living in mountainous and seacoast communities were analyzed. Information collected included a lifetime occupational history and details of specific work place physical activities. Radiographic severity at the knee and lumbar spine was determined by the Kellgren/Lawrence (K/L) grading system. RESULTS: The prevalence of K/L grade > or =2 knee OA and lumbar spondylosis among agricultural, forestry, and fishery workers was significantly higher than among clerical workers and technical experts in the overall population. For occupational activities, sitting on a chair had a significant inverse association with K/L grade > or =2 knee OA and lumbar spondylosis. Standing, walking, climbing, and heavy lifting were associated with K/L grade > or =2 knee OA, but were not associated with K/L grade > or =2 lumbar spondylosis. Kneeling and squatting were associated with K/L grade > or =3 knee OA. CONCLUSION: This cross-sectional study using a population-based cohort suggests that sitting on a chair is a significant protective factor against both radiographic knee OA and lumbar spondylosis in Japanese subjects. An occupational activity that includes heavy lifting appears to have a greater effect on knee OA than on lumbar spondylosis.