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 [1]. In Australia, osteoarthritis accounted for 19% of the total burden of disease due to musculoskeletal conditions in 2015 [2].

Perceived health status

2.1 x as likely

to have poor health among those with osteoarthritis compared with those without osteoarthritis

According to the ABS 2017–18 National Health Survey, 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 self-assessed health of people aged 45 years and over, between those with and without osteoarthritis. Those with osteoarthritis had higher rates of ‘poor’ (11%25) and ‘fair’ (22%25) health compared with those without osteoarthritis (5%25 and 12%25, respectively). People with and without osteoarthritis had similar rates of ‘good’ health (31%25). People with osteoarthritis were less likely to describe their health as ‘very good’ (29%25) and ‘excellent’ (7%25), compared with those without osteoarthritis (34%25 and 18%25, respectively).

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS 2019 [3] (Data table).

Pain

Over 1 in 2 

Australians with osteoarthritis have 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 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 [4, 5].

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 (Table 2.5) [3].

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 [3] (Data table).

Psychological distress

1 in 5 

Australians with osteoarthritis have 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 2017–18, 1 in 5 (21%) Australian adults with osteoarthritis experienced high or very high levels of distress. This was 2 times as likely 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 [3] (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 [7].

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. According to the ABS National Health Survey 2017–18, among people aged 45 and over with osteoarthritis:

  • 38% also had back problems compared with 23% of people without osteoarthritis
  • 30% also had mental and behavioural conditions compared with 19% of people without osteoarthritis
  • 22% also had osteoporosis compared with 6% of people without osteoarthritis (Figure 4).

For this analysis, the selected comorbidities are heart, stroke and vascular disease, back problems, mental and behavioural conditions, asthma, diabetes, COPD, osteoporosis, kidney disease 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 heart, stroke and vascular disease, back problems, mental and behavioural conditions, asthma, COPD, osteoporosis, kidney disease, and diabetes remained significantly higher for people with osteoarthritis compared with those without. 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 [8], in addition to a poorer quality of life [9] 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.

Note: proportions do not total 100% as one person may have more than one additional diagnosis.

Source: AIHW analysis of ABS 2019 [3] (Data table).

Data notes

The comorbidity data presented here are based on self-reported data from the Australian Bureau of Statistics National Health Survey (NHS). When interpreting self-reported data, it is important to recognise that because we rely on respondents providing accurate information, the outputs may not always be a true reflection of the situation.

In the 2017–18 NHS, the number and proportion of persons with long-term health conditions is presented as those who have ‘a current medical condition which has lasted, or is expected to last, for 6 months or more, unless otherwise stated’ [10]. For the conditions osteoarthritis, asthma, cancer, heart, stroke and vascular disease (HSVD), diabetes, kidney disease and mental and behavioural conditions, the estimates are based on: persons who reported having been told by a doctor or nurse that they had the condition/s and whether they reported that their condition was current and long-term; that is, their condition was current at the time of interview and had lasted, or was expected to last, 6 months or more. 

For HSVD and diabetes, estimates also included persons who reported they had had the conditions, but that these conditions were not current and long-term at the time of interview.

The conditions data collected for back problems and COPD are ‘as reported’ by respondents and do not necessarily represent conditions as medically diagnosed. However, as the data relate to conditions which had lasted, or were expected to last, for six months or more, there is considered to be a reasonable likelihood that medical diagnoses would have been made in most cases. The degree to which conditions have been medically diagnosed is likely to differ across condition types. See the National Health Survey: Users’ Guide, 2017–18 [11] for more information.

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. AIHW (Australian Institute of Health and Welfare) 2019. Australian Burden of Disease Study 2015: Interactive data on disease burden. Cat. no. BOD 24. Canberra: AIHW.
  3. ABS (Australian Bureau of Statistics) 2019. Microdata: National Health Survey, 2017–18, detailed microdata, DataLab. ABS cat. no. 4324.0.55.001. Canberra: ABS. Findings based on AIHW analysis of ABS microdata.
  4. Cooper RD, Kuh D & Hardy R 2010. Objectively measured physical capability levels and mortality: systematic review and meta-analysis. British Medical Journal 341:c4467.
  5. Blyth FM, Cumming R, Mitchell P & Wang JJ 2007. Pain and falls in older people. European Journal of Pain 11:564–571.
  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 2019. Disease expenditure in Australia. Cat. no. HWE 76. Canberra: AIHW. Viewed 13 June 2019.
  8. Parekh AK, Goodman RA, Gordon C, Howard K & The HHS Interagency Workgroup on Multiple Chronic Conditions 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, Kee F, Kenny RA & Savva GM 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.
  10. ABS 2018. National Health Survey: First Results, 2017–18. ABS cat. no. 4364.0.55.001. Canberra: ABS. Viewed 1 May 2019.
  11. ABS 2018. National Health Survey: Users’ Guide, 2017–18. Canberra: ABS. Viewed 1 May 2019.