Objective: To estimate synergistic effects of hip/knee osteoarthritis (OA) and comorbidities
on mobility or self-care limitations among older adults.
Methods: We used baseline, cross-sectional data from the Oxford Pain, Activity and Lifestyle
(OPAL) study. Participants were community-dwelling adults aged 65 years or older who
completed ...
Objective: To estimate synergistic effects of hip/knee osteoarthritis (OA) and comorbidities
on mobility or self-care limitations among older adults.
Methods: We used baseline, cross-sectional data from the Oxford Pain, Activity and Lifestyle
(OPAL) study. Participants were community-dwelling adults aged 65 years or older who
completed a postal questionnaire. Participants reported demographic information, hip/knee
OA, comorbidities and mobility and self-care limitations. We used Poisson regression
models to estimate the independent and combined relative risks (RR) of mobility or self-care
limitations, the relative excess risk due to interaction (RERI) between hip/knee OA and comorbidities, attributable proportion of the risk due to the interaction and the ratio of the
combined effect and the sum of the individual effects, known as the synergy index.
Results: Of the 4,972 participants included, 1,532 (30.8%) had hip/knee OA, and of them
42.9% reported mobility limitations and 8.4% reported self-care limitations. Synergistic
effects impacting self-care limitations were observed between hip/knee OA and anxiety (RR:
3.09, 95% Confidence Interval (CI): 2.00 to 4.78; RERI: 0.93, 95% CI: 0.01 to 1.90), and
between hip/knee OA and depressive symptoms (RR: 2.71, 95% CI: 1.75 to 4.20; RERI: 0.58,
95% CI: 0.03 to 1.48). The portion of the total RR attributable to this synergism was 30% and
22% respectively.
Conclusions: This study demonstrates that synergism between hip/knee OA and anxiety or
depressive symptoms contribute to self-care limitations. These findings highlight the
importance of assessing and addressing anxiety or depressive symptoms when managing
older adults with hip/knee OA to minimise self-care limitations.