Impact of osteoarthritis

Osteoarthritis 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 (Briggs et al. 2016). In Australia, osteoarthritis accounted for 19% of the total burden of disease due to musculoskeletal conditions in 2015 (AIHW 2019a).

Perceived health status

According to the ABS 2017–18 National Health Survey (NHS) people aged 45 and over with osteoarthritis are less likely to perceive their health as excellent or very good compared with people without osteoarthritis. People with osteoarthritis were 2.1 times as likely to describe their health as poor (11%) compared with those without osteoarthritis (5.0%) (Figure 1).

Figure 1: Self-assessed health of people aged 45 and over with and without osteoarthritis, 2017–18

This vertical bar chart compares the bodily pain experienced by people aged 45 years and older, between those with and without osteoarthritis. Those with osteoarthritis had higher rates of ‘mild’ (19%25), ‘moderate’ (37%25), ‘severe’ (16%25) and ‘very severe’ (5%25) levels of pain compared with those without arthritis (17%25, 20%25, 6%25 and 1.7%25 respectively). Those with osteoarthritis had lower rates of ‘very mild’ (14%25) and ‘none’ (no pain) (9%25) compared with those without arthritis (24%25 and 31%25 respectively).

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS 2019 (Data table).

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 with those without osteoarthritis. This increased risk is due to a number of factors caused by osteoarthritis, such as decreased physical activity, joint instability, medication use and pain (Cooper et al. 2010).

In 2017–18, over half of people (58%) with osteoarthritis experienced ‘moderate’ to ‘very severe’ pain in the last 4 weeks. People with osteoarthritis were also 2.9 times as likely to have ‘very severe pain’ (4.9%) compared with those without the condition (1.7%) (Figure 2). In addition, almost half (48%) of people with osteoarthritis described their pain as having a ‘moderate’ to ‘extreme’ interference with their normal work during the last 4 weeks, compared with 22% in people without osteoarthritis.

Figure 2: Pain(a) experienced by people aged 45 and over with and without osteoarthritis, 2017–18

This vertical bar chart compares the bodily pain experienced by people aged 45 years and older, between those with and without osteoarthritis. Those with osteoarthritis had higher rates of ‘mild’ (19%25), ‘moderate’ (37%25), ‘severe’ (16%25) and ‘very severe’ (5%25) levels of pain compared with those without arthritis (17%25, 20%25, 6%25 and 1.7%25 respectively). Those with osteoarthritis had lower rates of ‘very mild’ (14%25) and ‘none’ (no pain) (9%25) compared with those without arthritis (24%25 and 31%25 respectively).

(a) Bodily pain experienced in the 4 weeks prior to interview.

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS 2019 (Data table).

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 a person’s mental health and, consequently, their quality of life (Sharma et al. 2016).

According to the NHS 2017–18, one in 5 (21%) Australian adults with osteoarthritis experienced high or very high levels of distress. This was 2 times as high as those without the condition (11%) (Figure 3).

Figure 3: Psychological distress(a) experienced by people aged 45 and over with and without osteoarthritis, 2017–18

This vertical bar chart compares self-reported distress levels experienced by people aged 45 and over, between those with and without osteoarthritis. Those with osteoarthritis had higher rates of ‘moderate’ (25%25), ‘high’ (12%25) and ‘very high’ (9%25) distress levels, compared with those without arthritis (19%25, 8%25 and 3.6%25 respectively). Those with osteoarthritis had lower rates of ‘low’ distress levels (54%25) compared with those without osteoarthritis (70%25).

(a) Psychological distress is measured using the Kessler Psychological Distress Scale (K10), which involves 10 questions about negative emotional states experienced in the previous 4 weeks. The scores are grouped into Low: K10 score 10–15, Moderate: 16–21, High: 22–29, Very high: 30–50.

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS 2019 (Data table).

Economic impact

In 2015–16, osteoarthritis cost the Australian health system an estimated $3.5 billion, representing 28% of disease expenditure on musculoskeletal conditions and 3% of total disease expenditure (AIHW 2019b).

Comorbidities of osteoarthritis

People with osteoarthritis often have other chronic conditions. Comorbidity is the term used when two or more health conditions occur at the same time. For this analysis, the selected comorbidities were reported:

  • heart, stroke and vascular disease
  • kidney disease
  • arthritis
  • mental and behavioural conditions
  • asthma
  • diabetes
  • chronic obstructive pulmonary disease (COPD)
  • osteoporosis
  • cancer.

According to the ABS NHS 2017–18, among people aged 45 and over with osteoarthritis:

  • 38% also had back problems compared with 23% of people without osteoarthritis
  • 31% also had mental and behavioural conditions compared with 20% of people without osteoarthritis
  • 22% also had osteoporosis compared with 6% of people without osteoarthritis (Data tables - Table 2.5)

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 the selected comorbidities (excluding cancer) remained significantly higher for people with osteoarthritis compared with those without (Figure 4). There was no significant difference for 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 (Parekh et al. 2011), in addition to a poorer quality of life (McDaid et al. 2013) and more complex clinical management and increased health costs.

Figure 4: Prevalence of other chronic conditions in people aged 45 and over with and without osteoarthritis, 2017–18

This vertical bar chart compares the prevalence of chronic conditions (including back problems, mental and behavioural conditions, osteoporosis, heart stroke and vascular disease, asthma, diabetes, COPD, cancer, and kidney disease) among those with and without osteoarthritis. Those with osteoarthritis had higher rates of all chronic conditions compared with those without osteoarthritis.

Notes:

  1. Age-standardised to the 2001 Australian population.
  2. Proportions do not total 100% as one person may have more than one additional diagnosis.

Source: AIHW analysis of ABS 2019 (Data table).

Data notes

The National Health Survey (NHS) uses three factors to determine whether or not a person is counted as having a particular condition: whether the condition is current, whether it is long term and whether it was medically diagnosed. The combination of these factors required for a person to count as having the condition varies according to the nature of the condition. For example, some conditions, such as diabetes and HSVD, once diagnosed, are seen to be lifelong. Even if a person no longer reports symptoms, they still count as having the condition. While other conditions, such as depression, asthma, cancer or back problems, can be lifelong, episodic or in complete remission.

Most conditions do not need the respondent to have been diagnosed by a doctor or nurse. The respondent is counted if they said they have the condition. However, in cases where the respondent said they had diabetes or HSVD and that

Condition

Current

Long term

Has the condition been diagnosed by a doctor or nurse?

Table 1: Definitions used for chronic conditions

Asthma

current

long term

no diagnosis required

Back problems

current

long term

no diagnosis required

Cancer

current

long term

no diagnosis required

COPD

current

long term

no diagnosis required

Diabetes

(2 combinations)

current

long term

no diagnosis required

ever had

not long term

diagnosis required

Heart, stroke and vascular disease (HSVD)

(2 combinations)

current

long term

no diagnosis required

ever had

not long term

diagnosis required

Kidney disease

current

long term

no diagnosis required

Mental and behavioural conditions

current

long term

no diagnosis required

Osteoporosis

current

long term

no diagnosis required

Osteoarthritis

current

long term

no diagnosis required

Note: Please see the 2017–18 NHS User Guide for more information on the definitions of the conditions.