OA Prevalence and Burden - Osteoarthritis Action Alliance (2022)

Osteoarthritis is common and increasing in prevalence, resulting in enormous personal and societal costs.

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Arthritis is a serious health crisis. CDC estimates that 1 in 4 (or 54.4 million) US adults have some form of arthritis, a figure that is projected to reach 78 million by the year 2040.1 While there are estimated to be more than 100 types of arthritis, osteoarthritis (OA) is the most common form of arthritis, affecting 32.5 million US adults.2 The high prevalence of arthritis manifests in enormous societal and personal costs.

(Video) Impact of Osteoarthritis in Military Personnel and Veterans

Figure 1: Future Projections of Arthritis3

OA Prevalence and Burden - Osteoarthritis Action Alliance (1)

PREVALENCE BY AGE, GENDER, AND ETHNICITY

Age

  • 43% of people with OA are 65 or older and 88% of people with OA are 45 or older.2
  • Annual incidence of knee OA is highest between 55 and 64 years old.6
  • More than half of individuals with symptomatic knee OA are younger than 65.6

Gender

  • 62% of individuals with OA are women.2
  • Among people younger than 45, OA is more common among men; above age 45, OA is more common in women.6

Ethnicity

  • 78% of individuals with OA are non-Hispanic whites.2
  • However, within their own race/ethnic groups, non-Hispanic black and Hispanic populations have higher rates of OA than non-Hispanic whites.2
  • American Indians report among the highest prevalence of arthritis of any population in the US.10
  • Documented musculoskeletal health disparities persist, with arthritis having a greater impact on people of color than Whites.1,12,13
  • See Patient Burden/Activity & Work Limitations below for more details on racial disparities in OA.

THE BURDEN OF OSTEOARTHRITIS2,4

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PATIENT BURDEN

Pain

  • People with OA experience greater pain, fatigue, levels of disability, andOA Prevalence and Burden - Osteoarthritis Action Alliance (3)activity limitations than people of their comparable age.4
  • While arthritis pain is extremely individualized, severe joint pain is not uncommon. Recent estimates suggest that one-fourth of adults with arthritis experience severe joint pain, characterized by a score of 7 or greater on the 0-10 pain scale.5
  • Severe joint pain occurs more often in middle-aged adults (45-64), women, non-Hispanic blacks, Hispanics, those with a disability, and in people with the following concurrent health conditions: fair/poor health, obesity, diabetes, heart disease, and serious psychological distress.5
  • 99% of all hip and knee replacements are done to address pain and functional limitations.1
  • Over 50% of people with knee OA will have a total knee replacement done during their lifetime.6

Pain- both chronic and episodic- can result in depression and other mood disturbances, functional disabilities, and work limitations.

(Video) July 15, 2020 OAAA Lunch and Learn - Overview of the ACR Guidelines for OA Management

Depression and Social Isolation

  • One-third of people with arthritis over the age of 45 suffer from depression or anxiety.1
  • People with OA are likely at greater risk for depression because of increased disability and fatigue associated with their pain.7
  • People with doctor-diagnosed arthritis report more days in the last month of poor mental health (5.4 days vs 2.8 days for people without arthritis).2
  • Social isolation and loneliness are often evident among people with osteoarthritis and other chronic musculoskeletal diseases. There appears to be a bi-directional relationship with pain impacting social isolation and loneliness, and vice versa.8

Activity Limitations

  • Almost 44% of people with arthritis have “arthritis-attributable activity limitations,” defined as self-reported limitations in “usual activities” because of arthritis symptoms1
  • By 2040, 11.4% of all adults will experience arthritis-attributable activity limitations (AAALs).9
  • Blacks with knee OA have greater prevalence, severity, progression, and worse pain and function compared with Whites.14
  • Over 60% of American Indians report AAALs and mobility restrictions.1,15,17

Work Limitations1

  • 30% of adults with arthritis find stooping, bending, or kneeling very difficult.
  • 20% cannot or find it very difficult to walk 3 blocks or push/pull large objects.
  • People with OA (working age) experience lower employment rates than those without OA. Research suggests that arthritis-related activity limitations might contribute to their lack of employment.
  • Latinos are more likely to report greater pain, functional limitations, and work limitations than non-Latino Whites.12,15,16

Figure 2: Arthritis-Attributed Limitations2

OA Prevalence and Burden - Osteoarthritis Action Alliance (4)

ECONOMIC BURDEN

The overall economic burden associated with OA in the US is estimated at $136.8 billion annually.2 This stunning figure has more than doubled over the last decade. For perspective, the annual economic cost of arthritis surpasses that of tobacco-related health effects, cancer, and diabetes. Direct medical costs reach $65 billion annually, with annual all-cause per person direct costs reaching $11,502.2

  • Because of OA, an estimated 1 million knee and hip replacements are completed each year.1
  • Knee OA contributes to more than $27 billion in health care costs each year.6
  • In 2013, OA was the 2nd most costly health condition treated in hospitals in the US, accounting for 4.3% of all hospitalization costs.10
  • In 2013, total lost wages due to any form of arthritis were $164 billion, or $4,040 less per adult with arthritis compared to those without.10
  • Increased absenteeism among workers with OA is fairly well documented, with workers with OA missing an average of 2 more days per year than workers without OA. Presenteeism, or loss of productivity while on the job, is less easy to calculate but is no less costly for workers or businesses.11
OA Prevalence and Burden - Osteoarthritis Action Alliance (5)CLINICAL TAKE-HOME POINTS
      • Arthritis is a serious disease resulting in enormous societal and personal costs.
      • Pain from OA can result in depression and other mood disturbances, functional disabilities, and work limitations.
      • The overall economic burden of OA in the US is estimated at almost $140 billion annually.
(Video) OACareTools: Engaging primary care providers in osteoarthritis prevention and management
REFERENCES
    1. Barbour KE, Helmick CG, Boring M, Brady TJ. Vital Signs: Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation – United States, 2013-2015. MMWR Morb Mortal Wkly Rep. 2017;66(9):246-253.
    2. United States Bone and Joint Initiative. The Burden of Musculoskeletal Diseases in the United States (BMUS). In: In. Fourth ed. Rosemont, IL. 2018: Available at https://www.boneandjointburden.org/fourth-edition. Accessed June 12, 2019.
    3. Centers for Disease Control and Prevention. 2003 National Health Interview Survey; 2030 Census projected population. Available at https://www.cdc.gov/arthritis/data_statistics/national-statistics.html. Accessed January 19, 2019.
    4. Osteoarthritis Research Society International. Osteoarthritis: A Serious Disease, submitted to the U.S. Food and Drug Administration. 2016. https://www.oarsi.org/sites/default/files/docs/2016/oarsi_white_paper_oa_serious_disease_121416_1.pdf. Accessed March 27, 2019.
    5. Barbour KE, Boring M, Helmick CG, Murphy LB, Qin J. Prevalence of Severe Joint Pain Among Adults with Doctor-Diagnosed Arthritis – United States, 2002-2014. MMWR Morb Mortal Wkly Rep. 2016;65(39):1052-1056.
    6. Arthritis Foundation. Arthritis by the Numbers. In: Atlanta, GA: Arthritis Foundation; 2019: https://www.arthritis.org/getmedia/e1256607-fa87-4593-aa8a-8db4f291072a/2019-abtn-final-march-2019.pdf. Accessed May 13, 2022.
    7. Hawker GA, Gignac MA, Badley E, et al. A longitudinal study to explain the pain-depression link in older adults with osteoarthritis. Arthritis Care Res (Hoboken). 2011;63(10):1382-1390.
    8. Smith TO, Dainty JR, MacGregor A. Trajectory of social isolation following hip fracture: an analysis of the English Longitudinal Study of Ageing (ELSA) cohort. Age Ageing. 2018;47(1):107-112.
    9. Hootman JM, Helmick CG, Barbour KE, Theis KA, Boring MA. Updated Projected Prevalence of Self-Reported Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation Among US Adults, 2015-2040. Arthritis Rheumatol. 2016;68(7):1582-1587.
    10. Centers for Disease Control and Prevention. Arthritis Cost Statistics Available at https://www.cdc.gov/arthritis/data_statistics/cost.htm. Published 2018. Accessed January 19, 2019.
    11. Menon J. Osteoarthritis related absenteeism and activity limitations. Osteoarthritis and Cartilage. 2015;23:A343.
    12. Bolen J, Schieb L, Hootman JM, et al. Differences in the prevalence and severity of arthritis among racial/ethnic groups in the United States, National Health Interview Survey, 2002, 2003, and 2006. Prev Chronic Dis. 2010;7(3):A64.
    13. Huff T, Scott M. Musculoskeletal Health Disparities in America. MOJ Orthopedics & Rheumatology. 2017;7(6):00290.
    14. Callahan LF, Cleveland RJ, Allen KD, Golightly Y. Racial/Ethnic, Socioeconomic, and Geographic Disparities in the Epidemiology of Knee and Hip Osteoarthritis. Rheumatic Disease Clinics of North America. 2021;47(1):1-20.
    15. Theis KA, Murphy LB, Guglielmo D, et al. Prevalence of Arthritis and Arthritis-Attributable Activity Limitation – United States, 2016-2018. MMWR Morb Mortal Wkly Rep. 2021;70(40):1401-1407.
    16. Guglielmo D, Murphy L, Boring M, et al. State-Specific Severe Joint Pain and Physical Inactivity Among Adults with Arthritis — United States, 2017. MMWR Morb Mortal Wkly Rep 2019. 2017;68:381-387. DOI: http://dx.doi.org/10.15585/mmwr.mm6817a2.
    17. Ferucci ED, Schumacher MC, Lanier AP, et al. Arthritis prevalence and associations in American Indian and Alaska Native people. Arthritis Rheum. 2008;59(8):1128-1136.

FAQs

How does gender factor into the prevalence of OA? ›

Women appear to use more health care, have higher OA prevalence, clinical pain and inflammation, decreased cartilage volume, physical difficulty, and smaller joint parameters and dimensions, as compared to men.

What are the 5 most common risk factors for OA? ›

Factors that can increase your risk of osteoarthritis include:
  • Older age. The risk of osteoarthritis increases with age.
  • Sex. Women are more likely to develop osteoarthritis, though it isn't clear why.
  • Obesity. ...
  • Joint injuries. ...
  • Repeated stress on the joint. ...
  • Genetics. ...
  • Bone deformities. ...
  • Certain metabolic diseases.
16 Jun 2021

How does OA affect ROM? ›

Patients with knee OA showed decreased knee flexion ROM during stance phase (39.7%) compared to controls. This gait change has been reported in previous studies that examined the changes in gait patterns between patients with knee OA and healthy controls [14–16].

Why osteoarthritis is more common in females? ›

Another important factor that may put women at risk for osteoarthritis of the knee is a history of knee injury. It has been well established that women have increased incidence of anterior cruciate ligament (ACL) injuries and that these injuries lead to future osteoarthritis regardless of gender [20, 21].

Which factor is most likely to contribute to the development of osteoarthritis? ›

Joint injury or overuse such as knee bending and repetitive stress can damage a joint and contribute to the development of osteoarthritis in that joint.

What is the root cause of osteoarthritis? ›

Primary osteoarthritis has no known cause. Secondary osteoarthritis is caused by another disease, infection, injury, or deformity. Osteoarthritis starts with the breakdown of cartilage in the joint. As the cartilage wears down, the bone ends may thicken and form bony growths (spurs).

What is the most effective treatment for osteoarthritis? ›

Exercise. Exercise is one of the most important treatments for people with osteoarthritis, whatever your age or level of fitness. Your physical activity should include a combination of exercises to strengthen your muscles and exercises to improve your general fitness.

What exercises make osteoarthritis worse? ›

With osteoarthritis, it is best to avoid activities that can stress your joints to minimize further joint inflammation and pain.
...
High-impact activities that can worsen symptoms of osteoarthritis in your hips or knees include:
  • Running.
  • Jumping.
  • Deep squatting and bending.
  • Stair climbing.
  • Hiking.
  • Prolonged standing.
11 Mar 2022

What is the difference between arthritis and osteoarthritis? ›

Osteoarthritis is a so-called mechanical condition characterized by the gradual wearing down of cartilage in the joints. Aging is the most common risk factor for osteoarthritis. Arthritis, on the other hand, is not caused by the normal wear and tear of bones.

Is fish oil good for osteoarthritis? ›

Docosahexaenoic acid-rich fish oil supplementation alleviated chronic OA pain and burden in sedentary overweight/obese older adults. The reductions in OA pain and burden were accompanied by improvements in well-being.

Is rheumatoid arthritis more common in males or females? ›

We found that the prevalence of RA is higher in females than males, the incidence is 4-5 times higher below the age of 50, but above 60-70 years the female/male ratio is only about 2. Smoking is a consistent predictor of RA in males, but findings have been more inconsistent in females.

What age group is affected by osteoarthritis? ›

Osteoarthritis is the most common form of arthritis among older people, and it is one of the most frequent causes of physical disability among older adults. The disease affects both men and women. Before age 45, osteoarthritis is more common in men than in women. After age 45, osteoarthritis is more common in women.

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