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  • CDC: Arthritis Affects 1 in 4 in US; More Emphasis on Physical Activity Needed

    The US Centers for Disease Control and Prevention's (CDC's) latest snapshot of arthritis prevalence, severity, and related physical inactivity reported in 2017 looks a lot like its previous one, based on 2015 data. As then, an estimated 1 in 4 US adults have the condition, almost 27% of whom experience severe joint pain. Making matters worse, says CDC, of those with arthritis, around a third report that they don't engage in any physical activity, the very thing that "can improve physical functioning in adults with joint conditions."

    The latest report is based on a nationwide survey conducted in 2017 in which 435,331 adults across the country responded to questions related to whether they have been diagnosed with arthritis, rheumatoid arthritis (RA), lupus, gout, or fibromyalgia; the severity of pain they experienced during the past 30 days; and their participation in any PA (other than PA associated with their jobs) over the past month. Researchers then compared these data with respondent demographics, including geographic areas, to get a picture of how arthritis is affecting the country.

    The findings point to a position long-supported by APTA: increased PA among individuals with arthritis can have a marked impact on reducing pain severity and increasing function. The association offers resources on encouraging healthy, active lifestyles at APTA's Prevention, Wellness, and Disease Management webpage as well as information on arthritis management through community programs. Members also can dive deeper into the issues by joining APTA's Council on Prevention, Health Promotion, and Wellness in Physical Therapy. Patient-focused resources are available through APTA's MoveForwardPT.com website; additionally the Osteoarthritis Action Alliance offers a free booklet to help consumers participate in its "Walk With Ease" program.

    Among the findings of the CDC study:

    Overall rates of arthritis remain about the same as they were in 2015—and follow the same geographic trends.
    The latest study revealed an estimated 54.4 million US adults have diagnosed arthritis—about 1 in 4 Americans. Of those, about 27% report experiencing severe joint pain. From a geographic perspective, prevalence and pain severity varies by state but are worse in Appalachia and the Lower Mississippi Valley. Prevalence ranges from a low of 15.7% in Washington, DC, to 34.6% in West Virginia, with severe joint pain rates varying from a low of 30.3% in Colorado to 45.2% in Mississippi.

    The prevalence of arthritis increased with age and was higher for some demographic groups, including women.
    Among adults aged 18-44, 8.1% reported being told they had arthritis, RA, lupus, gout, or fibromyalgia. That rate climbed to 50.4% among adults 65 and older. More women than men reported having arthritis (25.4% vs 19.1%), as did adults with obesity compared with healthy weight or underweight adults (30.4% vs. 17.9%). Among ethnic groups, non-Hispanic American Indian/Alaska Natives reported a 29.7% prevalence, while other groups reported rates ranging from 12.8% to 25.5%. Hispanic and non-Hispanic Asians reported the lowest arthritis prevalence among ethnic groups.

    About 1 in 3 respondents with arthritis reported severe joint pain, but that rate declined with age.
    Overall, the rates of "no/mild," "moderate," and "severe" joint pain reported was 36.2%, 33%, and 30.8%, respectively. Among respondents who reported severe joint pain, the rates dropped from 33% of those 18-44 to 25.1% among adults 65 and older.

    Higher rates of severe joint pain were associated with education, socioeconomic status, and sexual orientation, among other characteristics.
    Age-standardized severe joint pain was reported at rates above 40% for respondents who had less than a high school diploma (54.1%) and respondents living at or below 125% of the poverty level (51.6%). Among other demographic groupings, severe joint pain prevalence above 40% was recorded for non-Hispanic blacks (50.9%), retired persons (45.8%), Hispanics (42%), non-Hispanic American Indians/Alaskan Natives (42%), and individuals identifying as lesbian/gay/bisexual/queer/questioning (40.7%, but reported in only 27 states). Two-thirds of those reporting arthritis and identified as unable to work or disabled reported severe pain.

    PA inactivity prevalence varied by socioeconomic factors, too, and included a geographic element.
    Overall, physical inactivity increased with reported pain levels, from an inactivity rate of 22% among those with no/mild pain to a 47% inactivity rate for those reporting severe pain. Groups whose rates of reporting little or no PA in the past month were above 40% included respondents with less than a high school diploma (46.4%) and those at or below 125% of the poverty level (42.6%). Overall inactivity rates also increased as rurality increased, ranging from a 30.7% rate in large metro centers to 38.7% in noncore rural areas.

    In its discussion of the findings, CDC focuses much of its attention on PA levels and engages in a kind of collective head-scratch as to why more Americans aren't pursuing "an inexpensive intervention that can reduce pain, prevent or delay disability and limitations, and improve mental health, physical functioning, and quality of life with few adverse effects."

    "Arthritis-appropriate, evidence-based, self-management programs and low-impact, group aerobic, or multicomponent physical activity programs are designed to safely increase physical activity in persons with arthritis," the CDC states in the report. "These programs are available nationwide and are especially important for those populations that might have limited access to health care, medications, and surgical interventions."

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.