Vigorous exercise can slow down arthritis

Almost 60 percent of Americans age 65 and older suffer from some form of arthritis, a progressive joint disease which is the leading cause of disability in the United States. For more than 1 in 10 sufferers, arthritis makes simple, everyday tasks, from walking up a flight of stairs to bathing and dressing, extremely difficult and by 2010, the disease is expected to affect almost 40 million Americans over age 65, increasing the ranks of senior citizens with disabilities that limit independent living.

In an attempt to avert an epidemic of disability in the future and ease the burden on Medicare, researchers are trying to gain a comprehensive understanding of the disease to better manage all the components – demographic, biological, socioeconomic, and behavioural – that contribute to functional decline in arthritis patients.

A team of researchers at Northwestern University have conducted a long-term study of various risk factors, based on a large national sample of older adults with arthritis. Their findings,offer good news for guiding effective prevention efforts.

Among the subjects – 5,715 women and men ages 65 and up – the strongest predictor of the loss of ability to perform basic activities of daily living after developing arthritis was the lack of regular vigorous physical activity.

All the patients, 5,715 women and men ages 65 and up, in the study were diagnosed with having arthritis or rheumatism and were drawn from a large national study of health among people of traditional retirement age. 64 percent of the patients were female, the majority were white, with 8.6 percent African Americans and 4.5 percent Hispanics. 20 percent of the subjects experienced some functional limitation.

All participants were evaluated for a wide range of risk factors, including age, education, income level, and the toll of other adverse health conditions and the researchers also noted potentially unhealthy behaviours, including smoking, alcohol use, extreme weight gain or loss, and a sedentary lifestyle.

Each subject's functional decline was monitored over the course of two years. It was found that during that time nearly 14 percent of the patients experienced a measurable decline in their ability to carry out daily activities. Functional ability deteriorated more frequently among women than men and far more frequently among minorities than Caucasians.

Other ailments, particularly diabetes, stroke, vision loss, depression, and cognitive impairment contributed to the high rates of functional decline among older women and ethnic minorities as did no alcohol use and, above all, the lack of regular vigorous physical activity. This was seen to be the most prevalent risk factor for functional decline among older arthritis patients, reported by over 64 percent of the subjects and when researchers adjusted for all other risk factors, lack of regular vigorous physical activity almost doubled a patient's odds for functional decline and eventual disability in basic daily tasks essential to maintaining independence.

The study's leading author, Dorothy Dunlop, Ph.D says the strong association between lack of regular vigorous physical activity and subsequent functional deterioration is particularly important from a public health point of view, since this risk factor is very common among persons with arthritis and can be changed through intervention. She says that more than 60 percent of adults with arthritis do not meet the U.S. Surgeon General's recommendations for physical activity.

The researchers, in order to provide a clearer picture of the benefits of exercise for even elderly arthritis patients, estimate that the expected two-year rates of functional decline if all the participants had regularly engaged in exercise or physical activity could have been reduced by as much as 32 percent.

http://www.interscience.wiley.com/journal/arthritis