Impact of osteoarthritis

Osteoarthritis (OA) can have a profound impact on every aspect of a person's life. Ongoing pain, physical limitations and depression can affect an individual's ability to engage in social, community and occupational activities [1]. In Australia, OA accounted for 17% of the total burden of disease due to musculoskeletal conditions in 2011 [2].

Perceived health status

2.3 x more likely to report poor health among those with osteoarthritis

According to the ABS 2014–15 National Health Survey, people aged 15 and over with OA are less likely to perceive their health as excellent, very good or good than people without the condition. People with osteoarthritis were 2.3 times as likely to report their health as poor (7.9%) compared to those without osteoarthritis (3.5%).

Figure 1: Self-assessed health of people aged 15 and over with and without osteoarthritis, 2014–15

This vertical bar chart compares the self-assessed health of people aged 15 years and over, between those with and without osteoarthritis. Those with osteoarthritis reported higher rates of ‘poor’ (7.9%25), ‘fair’ (18%25) and ‘good’ (36%25) health compared to those without osteoarthritis (3.5%25, 9.5%25 and 29%25 respectively). People with osteoarthritis were less likely to report ‘very good’ (23%25) and ‘excellent’ (10%25), compared to those without osteoarthritis (38%25 and 20%25 respectively).

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS Microdata: National Health Survey (NHS) 2014–15. ABS cat. no. 4324.0.55.001. Canberra: ABS. (Data table).

Physical impact

Over 1 in 2 Australians with osteoarthritis report moderate to very severe pain

Osteoarthritis can have a profound impact on a person’s physical health, as joint pain and physical limitations are major symptoms of osteoarthritis. Older people with osteoarthritis can also be more prone to falls compared to those without osteoarthritis. This increased risk is due a number of factors caused by osteoarthritis, such as decreased physical activity, joint instability, medication use and pain [3,4].

In 2014–15, over half of people (59%) with osteoarthritis experienced ‘moderate’ to ‘very severe’ pain in the last 4 weeks. People with osteoarthritis were also over 4 times more likely to report ‘very severe pain’ (5.2%) compared to those without the condition (1.2%) (Figure 2). In addition, almost half (43%) of people with osteoarthritis reported their pain had a ‘moderate’ to ‘extreme’ interference with their normal work during the last 4 weeks [5].

Figure 2: Pain experienced by people aged 18 and over with and without osteoarthritis, 2014–15

This vertical bar chart compares the pain experienced by people aged 18 years and older, between those with and without osteoarthritis. Those with osteoarthritis reported higher rates of ‘mild’ (20%25), ‘moderate’ (36%25), ‘severe’ (17%25) and ‘very severe’ (5.2%25) levels of pain compared to those without arthritis (18%25, 16%25 5.7%25 and 1.2%25 respectively). Those with osteoarthritis reported lower rates of ‘very mild’ (15%25) and ‘none’ (no pain) (6.3%25) compared to those without arthritis (24%25 and 34%25 respectively).

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS Microdata: National Health Survey (NHS) 2014–15. ABS cat. no. 4324.0.55.001. Canberra: ABS. (Data table).

Mental impact

1 in 6 Australians with osteoarthritis reported high or very high psychological distress

People with osteoarthritis commonly experience anxiety, depression and other mental health issues. Pain, physical limitations, poor treatment outcomes and increased pharmacotherapy can impact on a person’s mental health and consequently, their quality of life [6].

According to the NHS 2014–15, one in six (17%) Australian adults with osteoarthritis report very high levels of distress. This was over 5 times as likely compared to those without the condition (3.2%).

Figure 3: Psychological distress experienced by people aged 18 and over with and without osteoarthritis, 2014–15

This vertical bar chart compares self-reported distress levels experienced by people aged 18 and over, between those with and without osteoarthritis. Those with osteoarthritis reported higher rates of ‘moderate’ (22%25), ‘high’ (10%25) and ‘very high’ (17%25) distress levels, compared to those without arthritis (19%25, 7.7%25 and 3.2%25 respectively). Those with osteoarthritis reported lower rates of ‘low’ distress levels (50%25) compared to those without osteoarthritis (70%25).

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS Microdata: National Health Survey (NHS) 2014–15. ABS cat. no. 4324.0.55.001. Canberra: ABS. (Data table).

Economic impact

Based on AIHW disease expenditure data, $1.6 million was attributed to osteoarthritis in 2008-09 (the most recent year for which data are available). This accounted for 29% of health-care expenditure on arthritis and other musculoskeletal conditions. This expenditure consisted of:

  • $1,256 million on admitted patient costs (77%)
  • $282 million on out-of-hospital-costs (17%)
  • $99 million on prescription pharmaceuticals (6.0%).

Expenditure on OA may not be fully captured in these estimates due to a lack of comprehensive data, for example on allied health costs and over-the-counter medications such as paracetamol. It also does not measure indirect costs such as lost work productivity [7].

Comorbidities of osteoarthritis

People with OA often have other chronic conditions. Comorbidity is the term used when two or more health conditions occur at the same time. According to the ABS National Health Survey 2014–15, among people with OA:

  • 51% reported also having cardiovascular disease (CVD) compared with 15% of people without OA
  • 35% reported also having back problems compared with 14% of people without OA
  • 18% reported also having mental health problems compared with 11% of people without OA.

(Note: these components do not total 100% as one person may have more than one comorbidity. For this analysis, the selected comorbidities are CVD, back problems, mental health problems, asthma, diabetes, COPD and cancer).

Most chronic conditions are more common in older age groups. The average age of people with osteoarthritis is older than the average age of the general population, so people with osteoarthritis are more likely to have age-related comorbidities. After adjusting for differences in the age structure of people with and without osteoarthritis, the rates of CVD, back problems, mental health problems, asthma and diabetes remained significantly higher for people with osteoarthritis compared to those without. There was no significant difference for COPD and cancer. It is important to note that regardless of the differences in age structures, having multiple chronic health problems is often associated with worse health outcomes [8], in addition to a poorer quality of life [9] and more complex clinical management and increased health costs.

Some comorbidities, such as CVD, also reflect the underlying prevalence of these individual chronic conditions in the population.

Figure 4: Prevalence of other chronic conditions in people with osteoarthritis compared to people without osteoarthritis, 2014–15

This vertical bar chart compares the prevalence of chronic conditions (including CVD, back problems, mental health problems, asthma, diabetes, COPD and cancer) among those with and without osteoarthritis. Those with osteoarthritis had higher rates of all chronic conditions compared to those without osteoarthritis.

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS Microdata: National Health Survey (NHS) 2014–15. ABS cat. no. 4324.0.55.001. Canberra: ABS. (Data table).

References

  1. Briggs AM, Cross MJ, Hoy DG, Sànchez-Riera L, Blyth FM, Woolf AD et al. 2016. Musculoskeletal Health Conditions Represent a Global Threat to Healthy Aging: A Report for the 2015 World Health Organization World Report on Ageing and Health. Gerontologist 56: S243-S255.
  2. Australian Institute of Health and Welfare 2017. The burden of musculoskeletal conditions in Australia: a detailed analysis of the Australian Burden of Disease Study 2011. Australian Burden of Disease Study series no. 13. BOD 14. Canberra: AIHW.
  3. Cooper RD, Kuh D & Hardy R 2010. Objectively measured physical capability levels and mortality: systematic review and meta-analysis. British Medical Journal 341: c4467.
  4. Blyth FM, Cumming R, Mitchell P & Wang JJ. 2007. Pain and falls in older people. European Journal of Pain, 11: 564–571.
  5. Australian Bureau of Statistics (ABS) 2015. National Health Survey: First Results, 2014–15. Canberra: ABS.
  6. Sharma A, Kudesia P, Shi Q & Gandhi R. 2016. Anxiety and depression in patients with osteoarthritis: impact and management challenges. Open Access Rheumatology: Research and Reviews, 8: 103–113.
  7. AIHW 2014. Health-care expenditure on arthritis and other musculoskeletal conditions: 2008–09. Canberra: AIHW.
  8. 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.
  9. 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.