Does Osteoarthritis Increase the Risk for Social Isolation?

Social isolation is a common occurrence in community-dwelling older adults¹ and has been linked to various health outcomes including functional decline,² coronary heart disease,³ and all-cause mortality.⁴ Researchers sought to determine whether it might also be associated with osteoarthritis (OA) in this population.⁵

Investigators Examine OA and Social Isolation

Using data from the European Project on OSteoArthritis (EPOSA), a large European cohort of community-dwelling older adults aged 65 to 85 years, the researchers looked into a possible link between OA and social isolation. Their findings were published in the Journal of the American Geriatric Society.⁵

The investigators wanted to know whether participants were socially isolated when the study began and 12 to 18 months later. They used the Lubben Social Network Scale to measure the number and frequency of social contacts with friends and family members, and the Maastricht Social Participation Profile to measure engagement in social activities. They assessed clinical OA of the hip, knee, and hand at baseline based on participants’ medical history and physical examination findings.

OA Linked With Loneliness

At the beginning of the study, 382 of 1967 patients (19%) were deemed socially isolated. Those who weren’t socially isolated (1585 [81%]) were generally younger, better educated, and wealthier. They were significantly less likely to present with cognitive impairment, anxiety, depression, chronic lung disease, and stroke. They were in better overall health, more likely to partake in physical activity, had faster walking times, and had less physical function impairment.

Of the participants who weren’t socially isolated at baseline, 13% became socially isolated over the following 12 to 18 months. These patients presented with higher percentages of cognitive impairment, depression, and clinical OA. They had slower walking times, greater physical function impairment, lower pain tolerance, and greater stiffness.

Takeaway

The researchers concluded that their “data … suggest that OA is associated with incident social isolation, adjusting for cognitive impairment, depression, and worse walking times.” They added that clinicians should be aware that individuals with OA might be at increased risk for social isolation, and that future research on the subject is warranted.

References

1. Cudjoe TKM, Roth DL, Szanton SL, Wolff JL, Boyd CM, Thorpe RJ. The epidemiology of social isolation: national health and aging trends study [published online March 26, 2018]. J Gerontol B Psychol Sci Soc Sci. doi: 10.1093/geronb/gby037
2. Perissinotto CM, Stijacic Cenzer I, Covinsky KE. Loneliness in older persons: a predictor of functional decline and death. Arch Intern Med. 2012;172(14):1078-1083.
3. Thurston RC, Kubzansky LD. Women, loneliness, and incident coronary heart disease. Psychosom Med. 2009;71(8):836-842.
4. Rico-Uribe LA, Caballero FF, Martín-María N, Cabello M, Ayuso-Mateos JL, Miret M. Association of loneliness with all-cause mortality: a meta-analysis. PLoS One. 2018;13(1):e0190033.
5. Siviero P, Veronese N, Smith T, et al. Association between osteoarthritis and social isolation: data from the EPOSA study [published online September 17, 2019]. J Am Geriatr Soc. doi: 10.1111/jgs.16159