Florian Herbolsheimer

Relationships between physical performance and knee and hip osteoarthritis: findings from the European Project on Osteoarthritis (EPOSA)

BACKGROUND poor physical performance (PP) is known to be associated with disability, lower quality of life and higher mortality rates. Knee and hip osteoarthritis (OA) might be expected to contribute to poor PP, through joint pain and restricted range of movement. Both clinical and self-reported OA are often used for large-scale community and epidemiological studies. OBJECTIVE to examine the relationships between hip and knee OA and PP in a large data set comprising cohorts from six European countries. METHODS a total of 2,942 men and women aged 65-85 years from the Germany, Italy, Netherlands, Spain, Sweden and the UK were recruited. Assessment included an interview and clinical assessment for OA. PP was determined from walking speed, chair rises and balance (range 0-12); low PP was defined as a score of ≤9. RESULTS the mean (SD) age was 74.2 (5.1) years. Rates of self-reported OA were much higher than clinical OA. Advanced age, female gender, lower educational attainment, abstinence from alcohol and higher body mass index were independently associated with low PP. Clinical knee OA, hip OA or both were associated with a higher risk of low PP; OR (95% CI) 2.93 (2.36, 3.64), 3.79 (2.49, 5.76) and 7.22 (3.63, 14.38), respectively, with relationships robust to adjustment for the confounders above as well as pain. CONCLUSION lower limb OA at the hip and knee is associated with low PP, and for clinical diagnosis relationships are robust to adjustment for pain. Those at highest risk have clinical OA at both sites.

Self-perceived weather sensitivity and joint pain in older people with osteoarthritis in six European countries: Results from the European Project on OSteoArthritis (EPOSA)

BackgroundPeople with osteoarthritis (OA) frequently report that their joint pain is influenced by weather conditions. This study aimed to examine whether there are differences in perceived joint pain between older people with OA who reported to be weather-sensitive versus those who did not in six European countries with different climates and to identify characteristics of older persons with OA that are most predictive of perceived weather sensitivity.MethodsBaseline data from the European Project on OSteoArthritis (EPOSA) were used. ACR classification criteria were used to determine OA. Participants with OA were asked about their perception of weather as influencing their pain. Using a two-week follow-up pain calendar, average self-reported joint pain was assessed (range: 0 (no pain)-10 (greatest pain intensity)). Linear regression analyses, logistic regression analyses and an independent t-test were used. Analyses were adjusted for several confounders.ResultsThe majority of participants with OA (67.2%) perceived the weather as affecting their pain. Weather-sensitive participants reported more pain than non-weather-sensitive participants (M = 4.1, SD = 2.4 versus M = 3.1, SD = 2.4; p < 0.001). After adjusting for several confounding factors, the association between self-perceived weather sensitivity and joint pain remained present (B = 0.37, p = 0.03). Logistic regression analyses revealed that women and more anxious people were more likely to report weather sensitivity. Older people with OA from Southern Europe were more likely to indicate themselves as weather-sensitive persons than those from Northern Europe.ConclusionsWeather (in)stability may have a greater impact on joint structures and pain perception in people from Southern Europe. The results emphasize the importance of considering weather sensitivity in daily life of older people with OA and may help to identify weather-sensitive older people with OA.

Physical Activity Patterns Among Older Adults With and Without Knee Osteoarthritis in Six European Countries.

To investigate patterns of physical activity in older adults with knee osteoarthritis (OA) compared to older adults without knee OA across 6 European countries. We expect country‐specific differences in the physical activity levels between persons with knee OA compared to persons without knee OA. A varying degree of physical activity levels across countries would express a facilitating or impeding influence of the social, environmental, and other contextual factors on a physically active lifestyle.

Expression and Activity of the Small RhoGTPase Cdc42 in Blood Cells of Older Adults Are Associated With Age and Cardiovascular Disease

The small RhoGTPase Cdc42 is mechanistically linked to aging of multiple tissues and to rejuvenation of hematopoietic stem cells in mice. However, data validating Cdc42 activity and expression as biomarker for aging in humans are still missing. Here, we hypothesized that Cdc42 might serve as a novel biomarker of aging in older adults and therefore we determined Cdc42 activity and expression levels in peripheral blood cells from a cohort of 196 donors. We investigated the association of these parameters with both chronological and biological aging. We also tested in this cohort of older adults a recently published algorithm determining chronological age based on DNA methylation profiles. A positive correlation with chronological age was found for both the level of Cdc42 mRNA and the level of active Cdc42 protein (the GTP bound form). Notably, the level of Cdc42 mRNA as well as total protein showed a specific strong association to cardiovascular disease and Cdc42 mRNA levels also to a history of myocardial infarction. In summary, these data validate Cdc42 as a blood biomarker of both chronological aging as well as aging-associated diseases like cardiovascular disease and myocardial infarction.

Relationship Between Social Isolation and Indoor and Outdoor Physical Activity in Community-Dwelling Older Adults in Germany: Findings From the ActiFE Study

Objectives: Social relationships have a powerful effect on physical activity. However, it is unclear how physical activity patterns are associated with perceived social isolation. Methods: A cohort study was performed on 1,162 community-dwelling older adults. In cross-sectional analyses, social isolation was screened using the Lubben Social Network Scale (LSNS-6). Physical activity was measured by an accelerometer (activPAL). Participants kept a contemporary physical activity diary to report outdoor physical activity timeframes. Results: Low levels of physical activity were associated with perceived social isolation. Low indoor physical activity was associated with being socially isolated from family and low outdoor physical activity was associated with being socially isolated from friends and neighbors (-4.5 minutes; p=.012). Discussion: These findings suggest the need for a more nuanced assessment of non-kin networks and a differentiated analysis of the locations in which physical activity is done in order to understand how social isolation affects everyday physical activity.

Availability and use of neighborhood resources by older people with osteoarthritis: Results from the European Project on OSteoArthritis

This study examines the availability and use of neighborhood resources in relation to clinical lower limb osteoarthritis (LLOA) in older participants from six European countries. Of the 2757 participants (65-85 years), 22.7% had LLOA. Participants with LLOA made more use of places to sit (OR=2.50; CI: 1.36-4.60 in the UK), and less use of parks and walking areas (OR=0.30; CI: 0.12-0.75 in Sweden), compared to participants without LLOA, particularly in countries with high availability of resources. The results suggest that specific features of the environment impact the use of neighborhood resources by older adults with LLOA.

The Influence of Weather Conditions on Outdoor Physical Activity Among Older People With and Without Osteoarthritis in 6 European Countries.

BACKGROUND Older adults with osteoarthritis (OA) often report that their disease symptoms are exacerbated by weather conditions. This study examines the association between outdoor physical activity (PA) and weather conditions in older adults from 6 European countries and assesses whether outdoor PA and weather conditions are more strongly associated in older persons with OA than in those without the condition. METHODS The American College of Rheumatology classification criteria were used to diagnose OA. Outdoor PA was assessed using the LASA Physical Activity Questionnaire. Data on weather parameters were obtained from weather stations. RESULTS Of the 2439 participants (65-85 years), 29.6% had OA in knee, hand and/or hip. Participants with OA spent fewer minutes in PA than participants without OA (Median = 42.9, IQR = 20.0 to 83.1 versus Median = 51.4, IQR = 23.6 to 98.6; P < .01). In the full sample, temperature (B = 1.52; P < .001) and relative humidity (B = -0.77; P < .001) were associated with PA. Temperature was more strongly associated with PA in participants without OA (B = 1.98; P < .001) than in those with the condition (B = 0.48; P = .47). CONCLUSIONS Weather conditions are associated with outdoor PA in older adults in the general population. Outdoor PA and weather conditions were more strongly associated in older adults without OA than in their counterparts with OA.

Within-Person Pain Variability and Mental Health in Older Adults With Osteoarthritis: An Analysis Across 6 European Cohorts

Pain is a key symptom of osteoarthritis (OA) and has been linked to poor mental health. Pain fluctuates over time within individuals, but a paucity of studies have considered day-to-day fluctuations of joint pain in relation to affective symptoms in older persons with OA. This study investigated the relationship of pain severity as well as within-person pain variability with anxiety and depression symptoms in 832 older adults with OA who participated in the European Project on OSteoArthritis (EPOSA): a 6-country cohort study. Affective symptoms were examined with the Hospital Anxiety and Depression Scale, pain severity was assessed with the Western Ontario and McMaster Universities OA Index and the Australian/Canadian Hand Osteoarthritis Index, and intraindividual pain variability was measured using pain calendars assessed at baseline, 6, and 12 to 18 months. Age-stratified multiple linear regression analyses adjusted for relevant confounders showed that more pain was associated with more affective symptoms in older-old participants (74.1-85 years). Moreover, older-old participants experienced fewer symptoms of anxiety (ratio = .85, 95% confidence interval [CI], .77-.94), depression (ratio = .90, 95% CI, .82-.98), and total affective symptoms (ratio = .87, 95% CI, .79-.94) if their pain fluctuated more. No such association was evident in younger-old participants (65-74.0 years). These findings imply that stable pain levels are more detrimental to mental health than fluctuating pain levels in older persons. PERSPECTIVE This study showed that more severe and stable joint pain levels were associated with anxiety and depressive symptoms in older persons with OA. These findings emphasize the importance of measuring pain in OA at multiple time points, because joint pain fluctuations may be an indicator for the presence of affective symptoms.

Association between vitamin D concentration and dementia: A population-based cross-sectional study among elderly people in Southern Germany

P3-179 ASSOCIATION BETWEEN VITAMIN D CONCENTRATION AND DEMENTIA: A POPULATION-BASED CROSS-SECTIONAL STUDY AMONG ELDERLY PEOPLE IN SOUTHERN GERMANY Christine von Arnim, Florian Herbolsheimer, Matthias Riepe, Thorsten Nikolaus, Michael Denkinger, Richard Peter, Gudrun Weinmayr, Dietrich Rothenbacher, Wolfgang Koenig, Albert Ludolph, Gabriele Nagel, Department of Neurology University of Ulm, Ulm, Germany; Institute of Epidemiology andMedical Biometry, Ulm University, Ulm, Germany; Psychiatry II Ulm University, BKH G€unzburg, G€unzburg, Germany; Agaplesion Bethesda Clinic, Ulm University, Ulm, Germany; Agaplesion Bethesda Clinic, Ulm, Ulm, Germany; Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Department of Internal Medicine II Cardiology, University of Ulm Medical Centre, Ulm, Germany; Department of Neurology, Ulm University, Ulm, Germany. Contact e-mail: christine.arnim@uni-ulm.de