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Vigorous Activity Cuts Arthritis Disabilities

Inactivity Nearly Doubles Loss of Physical Function Among Seniors With Arthritis

By Miranda Hitti
WebMD Medical News Reviewed By Brunilda Nazario, MD
on Thursday, April 07, 2005

April 7, 2005 — Older adults with arthritis who do their best to get regular, vigorous physical activityarthritis who do their best to get regular, vigorous physical activity have an advantage over those who are sedentary.

“Lack of regular, vigorous physical activity … almost doubled the odds of functional decline after controlling for all risk factors,” says a study in April’s issue of Arthritis & Rheumatism.

If everyone in the study had gotten enough activity, decline in physical function could have been as much as 32% lower, the researchers estimate.

“Older persons with chronic conditions need to be encouraged to participate in physical activities, regardless of their current capabilities,” they write.

Arthritis and other rheumatic conditions are the leading causes of disability in the U.S., says the study. Nearly 60% of U.S. adults aged 65 and older have arthritis, and 10% of them say their daily activities are limited, the researchers note.

Trouble With Daily Life

Arthritis can be painful, and that may understandably make some patients want to avoid physical activity.patients want to avoid physical activity. But the new study says that’s not always a great idea.

More than 5,700 people with arthritis participated. All were at least 65 years old.

At the study’s start, nearly one in five said their physical function was limited, and some 13% had trouble with activities of daily life. Almost 6% said they had trouble with two or more activities, while twice as many reported problems with three or more daily tasks.

Men, Whites More Active

Many participants said they weren’t very active, but women and minorities were more likely to fall into that category.

Women were more likely than men to say they had a hard time with daily activities.

About 68% of women said they didn’t get regular, vigorous activity, compared to 57% of men. Among minorities of either sex, the rates were 73% for blacks, 70% for Hispanics, and 63% for whites or people of other races.

After two years, 14% of at-risk participants reported declines in physical function. That included 15% of all women in the study, 18% of Hispanics, and nearly 19% of black participants.

After evaluating various potentially unhealthy behaviors, the researchers found that lack of regular, vigorous physical activity nearly doubled the risk of functional decline. Almost two-thirds of the participants did not get regular physical activity.

More Problems 2 Years Later

The biggest predictor of limitations in daily activities was lack of regular vigorous physical activity. A decline in mental skills also predicted physical limitations in daily activity.

“Function declined less frequently in persons who engaged in regular, vigorous physical activity, regardless of their baseline ability,” write the researchers, who included Dorothy Dunlop, PhD, of Northwestern University’s medical school.

In other words, being as active as possible was beneficial. Health care providers can help design a plan to do that safely.

Lack of regular physical activity is a potentially modifiable risk factor which could substantially reduce functional decline and health care cost, they conclude.

SOURCES: Dunlop, D. Arthritis & Rheumatism, April 2005; vol 52: pp 1274-1282. News release, John Wiley & Sons, Inc.

Yahoo! News - Arthritis Inflammation Increases Cardiac Death Risk

NEW YORK (Reuters Health) - Systemic inflammation increases the risk of dying from cardiovascular disease in patients with rheumatoid arthritis, a new study shows, even after factoring in the effects of traditional cardiovascular risk factors and other illnesses.”

The rate of illness and death from cardiovascular disease is higher among rheumatoid arthritis patients, and there is increasing evidence that inflammation plays a key role in the development of atherosclerosis, also known as hardening of the arteries, Dr. Sherine E. Gabriel of the Mayo Clinic in Rochester, Minnesota, and colleagues report in the medical journal Arthritis and Rheumatism.

They therefore conducted a study to investigate if evidence of more severe inflammation in rheumatoid arthritis patients might be associated with an increased risk of death from cardiovascular disease.

Gabriel and colleagues looked at 603 patients with rheumatoid arthritis, representing all residents of Rochester 18 years or older who were diagnosed with rheumatoid arthritis between 1955 and 1995. Study subjects were followed for an average of 15 years.

The researchers found a number of factors and other illnesses increased the risk of cardiovascular death, including personal history of cardiovascular disease, high blood pressure, diabetes mellitus, cancer and history of alcoholism.

After accounting for these factors, the researchers found that three markers of inflammation were independently associated with a greater risk of cardiovascular death.

These included having at least three high erythrocyte sedimentation rate tests; rheumatoid arthritis vasculitis; and rheumatoid lung disease. Swelling of large joints also was associated with a greater risk of cardiovascular death.

In addition, the researchers found that corticosteroid drug use increased the risk of cardiovascular death among rheumatoid arthritis patients who had no history of heart disease, but reduced cardiovascular death risk among those who did have a history of heart disease.

While these drugs can promote high blood pressure and high cholesterol, the researchers note, their anti-inflammatory effects may benefit patients with existing heart disease.

The researchers suggest that new studies should investigate whether aggressive treatment to tightly control systemic inflammation in rheumatoid arthritis patients can reduce the risk of cardiovascular death — similar to the benefits of tightly controlling blood sugar levels in diabetics.

SOURCE: Arthritis and Rheumatism, March 2005.