About arthritis and its comorbidities

People with arthritis often have other chronic diseases and long-term conditions. These are referred to as ‘comorbidities’—two or more health problems occurring at the same time.

Comorbidity

Many different illnesses and health conditions can be classified under the broad heading of ‘chronic disease’. They often coexist, share common risk factors, and are increasingly being seen as acting together to determine the health status of individuals.

Having multiple chronic health problems or ‘comorbidities’ is often associated with worse health outcomes [1], in addition to a poorer quality of life [2] and more complex clinical management and increased health costs. There is a potential for integrating prevention and care and treating comorbid chronic diseases together, to keep people healthy for as long as possible.

As people age, they are more likely to have more than one health problem. Previous studies have reported that, of people aged 65 and over with arthritis, as many as one in two have high blood pressure, one in five heart disease, and one in seven diabetes [3].

Treatment and management

The existence of comorbidities can complicate treatment and management options for both arthritis and other chronic conditions and also make it harder for people to self-manage these conditions [4]. Arthritis often restricts physical activity and when it occurs with diabetes, heart disease, or obesity, the restriction can impede effective disease management.

Comorbidities can complicate treatment options

People with rheumatoid arthritis are more at risk of developing other chronic diseases [5]. The risk of cardiovascular disease in people with rheumatoid arthritis (12.9%) is similar to the risk of cardiovascular disease in people with Type 2 diabetes (12.4%) [6,7]. This risk may be increased due to the medications used to treat rheumatoid arthritis, such as glucocorticoids [7,8].

References

  1. Parekh AK, Goodman RA, Gordon C et al. 2011. Managing multiple chronic conditions: a strategic framework for improving health outcomes and quality of life. Public Health Reports 126:460–471.
  2. McDaid O, Hanly MJ, Richardson K et al. 2013. The effect of multiple chronic conditions on self-rated health, disability and quality of life among the older populations of Northern Ireland and the Republic of Ireland: a comparison of two nationally representative cross-sectional surveys. British Medical Journal Open 3:e002571. doi:10.1136/bmjopen-2013-002571.
  3. Caughey GE, Vitry AI, Gilbert AL et al. 2008. Prevalence of comorbidity of chronic diseases in Australia. BMC Public Health 8:221 doi:10.1186/1471-2458-8-221.
  4. Leeder S & Wells B 2012. Findings: Optimising prevention and the management of care for Australians with serious and continuing chronic illness. Menzies Centre for Health Policy, The University of Sydney.
  5. Ursum J, Korevaar JC, Twisk Jet al. 2013. Prevalence of chronic diseases at the onset of inflammatory arthritis: a population-based study. Family Practice 30:615–620.
  6. Van Halm VP, Peters MJ, Voskuyl AE et al. 2009. Rheumatoid arthritis versus diabetes as a risk factor for cardiovascular disease, a cross sectional study: the CARRE Investigation. Annals of the Rheumatic Diseases 68:1395–400.
  7. Peters MJ, van Halm VP, Voskuyl AE et al. Does rheumatoid arthritis equal diabetes mellitus as an independent risk factor for cardiovascular disease? A prospective study. Arthritis and Rheumatism 61(11):1571–1579.
  8. Liao KP & Solomon DH 2013. Traditional cardiovascular risk factors, inflammation and cardiovascular risk in rheumatoid arthritis. Rheumatology (Oxford) 52:45–52.