The prevalence of arthritis in the United States may have been greatly underestimated, particularly in people younger than 65 years, according to a study published recently in Arthritis and Rheumatology.

At this time, clinicians use a single survey question to assess the presence of arthritis, asking patients whether other practitioners have previously told them that they have the condition. This common practice occurs despite the fact that this survey also contains questions on joint symptoms.

To address this issue, the researchers developed a new survey in which chronic joint symptoms and their duration, particularly symptoms lasting for >3 months, are assessed, in addition to reports of prior arthritis diagnosis.

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A review of the 2015 National Health Interview Survey revealed that 91.2 million adults (36.8% of the total US population) are affected by arthritis, including 61.1 million (31.6%) aged 18 to 64 years. For adults <65 years, arthritis was diagnosed in 31.2% of women and 29.9% of men, whereas in people ≥65 years, arthritis prevalence is estimated to be 68.7% in women and 55.8% in men.

In the 33,672 National Health Interview Survey respondents, 16.7% and 13.5% of women and 19.3% and 15.7% of men aged 18 to 64 years and ≥65 years, respectively, experienced joint symptoms despite the absence of a prior diagnosis, highlighting the underdiagnosing of arthritis.

According to the researchers, the underestimation of arthritis prevalence, particularly in patients <65 years, indicates that the effect in terms of disability, costs, and lost productivity may have also been underestimated. These issues demand a more rigorous and robust form of surveillance, such as that recommended, to enhance accuracy and awareness and to improve effectiveness of prevention and treatment.

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