TY - JOUR
T1 - The Association of Osteoarthritis and Related Pain Burden to Incident Alzheimer's Disease and Related Dementias
T2 - A Retrospective Cohort Study of U.S. Medicare Beneficiaries
AU - Innes, Kim E.
AU - Sambamoorthi, Usha
N1 - Funding Information:
Research reported in this publication was supported in part by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number 2U54GM104942-02, WVCTSI and the Alzheimers Research and Prevention Foundation (ARPF). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the ARPF.
Funding Information:
In this retrospective cohort study of community-dwelling Medicare FFS beneficiaries, baseline OA was significantly and positively associated with likelihood of incident ADRD at follow-up; this association was most pronounced in those with OA accompanied by pain and appeared to be partially mediated by depression and anxiety. Clearly, additional rigorous prospective studies are needed to Research reported in this publication was supported in part by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number 2U54GM104942-02, WVCTSI and the Alzheimer’s Research and Prevention Foundation (ARPF). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the ARPF.
Publisher Copyright:
© 2020 - IOS Press and the authors. All rights reserved.
PY - 2020
Y1 - 2020
N2 - Background: Emerging evidence suggests osteoarthritis (OA) and related symptom burden may increase risk for Alzheimer's disease and related dementias (ADRD). However, longitudinal studies are sparse, and none have examined the potential mediating effects of mood or sleep disorders. Objective: To determine the association of OA and related pain to incident ADRD in U.S. elders. Methods: In this retrospective cohort study, we used baseline and two-year follow-up data from linked Medicare claims and Medicare Current Beneficiary Survey files (11 pooled cohorts, 2001-2013). The study sample comprised 16,934 community-dwelling adults≥65 years, ADRD-free at baseline and enrolled in fee-for-service Medicare. Logistic regression was used to assess the association of OA and related pain (back, neck, joint, neuropathic) to incident ADRD, explore the mediating inlfuence of mood and insomnia-related sleep disorders, and (sensitivity analyses) account for potential survival bias. Results: Overall, 25.5% of beneficiaries had OA at baseline (21.0% with OA and pain); 1149 elders (5.7%) were subsequently diagnosed with ADRD. Compared to beneficiaries without OA, those with OA were significantly more likely to receive a diagnosis of incident ADRD after adjustment for sociodemographics, lifestyle characteristics, comorbidities, and medications (adjusted odds ratio (AOR) = 1.23 (95% confidence interval (CI) 1.06, 1.42). Elders with OA and pain at baseline were significantly more likely to be diagnosed with incident ADRD than were those without OA or pain (AOR = 1.31, CI 1.08, 1.58). Sensitivity analyses yielded similar findings. Inclusion of depression/anxiety, but not sleep disorders, substantially attenuated these associations. Conclusion: Findings of this study suggest that: OA is associated with elevated ADRD risk, this association is particularly pronounced in those with OA and pain, and mood disorders may partially mediate this relationship.
AB - Background: Emerging evidence suggests osteoarthritis (OA) and related symptom burden may increase risk for Alzheimer's disease and related dementias (ADRD). However, longitudinal studies are sparse, and none have examined the potential mediating effects of mood or sleep disorders. Objective: To determine the association of OA and related pain to incident ADRD in U.S. elders. Methods: In this retrospective cohort study, we used baseline and two-year follow-up data from linked Medicare claims and Medicare Current Beneficiary Survey files (11 pooled cohorts, 2001-2013). The study sample comprised 16,934 community-dwelling adults≥65 years, ADRD-free at baseline and enrolled in fee-for-service Medicare. Logistic regression was used to assess the association of OA and related pain (back, neck, joint, neuropathic) to incident ADRD, explore the mediating inlfuence of mood and insomnia-related sleep disorders, and (sensitivity analyses) account for potential survival bias. Results: Overall, 25.5% of beneficiaries had OA at baseline (21.0% with OA and pain); 1149 elders (5.7%) were subsequently diagnosed with ADRD. Compared to beneficiaries without OA, those with OA were significantly more likely to receive a diagnosis of incident ADRD after adjustment for sociodemographics, lifestyle characteristics, comorbidities, and medications (adjusted odds ratio (AOR) = 1.23 (95% confidence interval (CI) 1.06, 1.42). Elders with OA and pain at baseline were significantly more likely to be diagnosed with incident ADRD than were those without OA or pain (AOR = 1.31, CI 1.08, 1.58). Sensitivity analyses yielded similar findings. Inclusion of depression/anxiety, but not sleep disorders, substantially attenuated these associations. Conclusion: Findings of this study suggest that: OA is associated with elevated ADRD risk, this association is particularly pronounced in those with OA and pain, and mood disorders may partially mediate this relationship.
KW - Alzheimer's disease and related dementias
KW - arthritis
KW - cognition
KW - dementia
KW - medicare current beneficiaries survey
KW - mood
KW - pain
KW - sleep
UR - http://www.scopus.com/inward/record.url?scp=85086052247&partnerID=8YFLogxK
U2 - 10.3233/JAD-191311
DO - 10.3233/JAD-191311
M3 - Article
C2 - 32333589
AN - SCOPUS:85086052247
SN - 1387-2877
VL - 75
SP - 789
EP - 805
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
IS - 3
ER -