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Differentiating knee pain phenotypes in older adults: a prospective cohort study

Citation

Pan, F and Tian, J and Cicuttini, F and Jones, G and Aitken, D, Differentiating knee pain phenotypes in older adults: a prospective cohort study, Rheumatology, 58, (2) pp. 274-283. ISSN 1462-0324 (2018) [Refereed Article]

Copyright Statement

Copyright 2018 the authors

DOI: doi:10.1093/rheumatology/key299

Abstract

Objective: To identify and validate knee pain phenotypes in an older population across different pain-related domains over 10.7 years.

Methods: A total of 963 participants (mean age 63 years) from a population-based older adult cohort study were studied at baseline and followed up at 2.6 (n = 875), 5.1 (n = 768) and 10.7 years (n = 563). Baseline demographic, psychological, lifestyle and comorbidities data were obtained and MRI was performed to measure knee structural pathology. WOMAC pain and pain at multiple sites were assessed by questionnaires at each time-point. Latent class analysis was used to identify knee pain phenotypes, considering sex, BMI, emotional problems, education level, comorbidities, number of painful sites and knee structural pathology.

Results: Three pain phenotypes were identified: Class 1: high prevalence of emotional problems and low prevalence of structural damage (25%); Class 2: high prevalence of structural damage and low prevalence of emotional problems (20%); Class 3: low prevalence of emotional problems and low prevalence of structural damage (55%). Participants within Class 1 and 2 had greater BMI, more comorbidities, a higher prevalence of radiographic knee OA and knee structural pathology compared with Class 3. Furthermore, compared with Class 2 and 3, WOMAC pain and number of painful sites were consistently greater at each time-point over 10.7 years in Class 1. Results were similar when the analyses were restricted to participants with radiographic knee OA.

Conclusion: Psychological and structural factors interact with each other to exacerbate pain perception, suggesting that tailored treatment approaches for older people with knee pain in clinical practice are needed.

Item Details

Item Type:Refereed Article
Keywords:knee osteoarthritis, pain, phenotypes, older adult, longitudinal study
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Rheumatology and Arthritis
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Skeletal System and Disorders (incl. Arthritis)
UTAS Author:Pan, F (Dr Feng Pan)
UTAS Author:Tian, J (Dr Jing Tian)
UTAS Author:Jones, G (Professor Graeme Jones)
UTAS Author:Aitken, D (Associate Professor Dawn Aitken)
ID Code:128515
Year Published:2018
Deposited By:Menzies Institute for Medical Research
Deposited On:2018-09-27
Last Modified:2019-04-08
Downloads:0

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