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Epidemiology

Epidemiology

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Published by: sebastoto778 on Jun 14, 2010
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05/20/2012

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W
hile some individuals who have arthritis leadactive, productive lives, others need assistance toaccomplish basic activities associated with daily liv-ing. Compared to people who do not have arthritis, those whohave arthritis:
s
experience more physical limitations,
s
have more financial difficulties,
s
have more occupational limitations,
s
are less satisfied with current circumstances, and
s
are less optimistic about the future.
Arthritis affects people of all ages
s
The elderly have high rates of arthritis. Although the elder-ly account for just 12 percent of the entire U.S. population, thepopulation with arthritis is split almost evenly between thoseage 65 and older and the rest of the population. Just over half of those with arthritis are under age 65, including almost200,000 children.
NATIONAL ACADEMY ON AN AGING SOCIETY
Arthritis
NATIONALACADEMY ON ANAGING SOCIETY
Number 5March 2000
A leading cause of disability in the United States 
Arthritis is among the most common chronic conditions in the United States. Itaffects some 40 million people—almost one out of six—at an annual cost of some $65billion. Almost one-quarter of this total—$15 billion—is for the direct costs of med-ical care. Lost wages account for some $50 billion in indirect costs related to arthri-tis.
1
Almost half of all elderly people have arthritis, and the elderly population is thefastest-growing segment of the U.S. population. Projections indicate that by 2020,almost 60 million people, or about 20 percent of the population, will have arthritis.
2
 C  OI   C  I   S I   G  C  OI  I   O S 
 C  G S   O  
 S 
 C  U 
WHO HASARTHRITIS?
SOURCE
:
National Academyon an Aging Society analysisof data from the
1994 National Health Interview Survey.
AGEGENDER
63%
FEMALE
37%
MALE
46%
65+
1%
0–17
17%
18–44
36%
45–64
 
s
Almost two-thirds of all Americans livingwith arthritis are women. In every agegroup the proportion of women who havearthritis is substantially higher than theproportion of men with the condition.
s
People with less education and lowerincomes have higher rates of arthritis.About one-third of the adult populationwith arthritis has less than a high schooleducation. This proportion is substantiallyhigher than the proportion of people in thegeneral population that have less than ahigh school education—20 percent.
s
Income differences between those whohave arthritis and the general populationmay be related, in part, to differences in edu-cational attainment between the groups. Inaddition, older women, who comprise a sub-stantial portion of those with arthritis, tendto have lower incomes than other groups.
Arthritis affects daily living
Older adults with arthritis spend similaramounts of time participating in volunteeractivities and caring for grandchildren astheir contemporaries who do not havearthritis. Still, in the most serious cases, peo-ple who have arthritis require assistancewith certain activities of daily living or
NATIONAL ACADEMY ON AN AGING SOCIETY
2
WHAT IS ARTHRITIS?
The term arthritis literally means “jointinflammation,” but it is generally used to referto a family of more than 100 different condi-tions that affect the joints and may also affectmuscles and other tissues. The most commonform of arthritis—degenerative arthritis orosteoarthritis—results from the breakdown ofthe tissue inside the joints. It affects more than20 million people in the U.S. The other form—inflammatory arthritis—results from swelling inthe joints. Rheumatoid arthritis is a commontype of inflammatory arthritis.
ADLs, such as bathing, dressing, using thetoilet, eating, walking, or other personal careactivities. One of 5 adults age 51 to 61 whohas arthritis has difficulty with one or moreADLs, but only 1 of 20 adults the same agewithout arthritis has difficulty with one ormore ADLs. Adults age 70 and older needmore help (see Figure 1).Relatives play a large role in providing carefor the elderly who have arthritis. Spousesprovide almost one-quarter of the care toelders with arthritis who need help withADLs. Children provide 39 percent of thecare, and others provide the remaining care.Some people with arthritis also need helpwith instrumental activities of daily living,or IADLs. These include preparing meals,shopping, using the telephone, managingmoney, taking medications, and doing lighthousework. Children and families provide71 percent of the help that elderly witharthritis need with IADLs.
FIGURE 1
Proportion of Population Needing Assistance with Activities of Daily Living 
SOURCE
:
National Academy on an Aging Societyanalysis of datafrom the
1992 Health and Retirement Study 
and the
1993 study of Asset and Health Dynamics Among the Oldest Old.
51 TO 6170+
6050403020100
   P   E   R   C   E   N   T
WITH ARTHRITISWITHOUT ARTHRITIS
2355021
AGE
 
People with arthritis areless healthy than others
There are significant differences in self-reported health status for those who havearthritis and those who do not. Among thepopulation with arthritis, only 34 percentsay they are in excellent or very good health,compared to 71 percent of those who do nothave arthritis (see Figure 2). One-third of thepopulation with arthritis report fair or poorhealth, compared to just 7 percent of thepopulation without arthritis.People who have arthritis are more like-ly to report that they stayed in bed becauseof an illness or an impairment. Some 32percent of those who have arthritis and just 15 percent of those who do not havearthritis report that they spent five or moredays in bed in the previous year. In 12months, almost 3 million people spent fiveor more days in bed because of theirarthritic condition.
NATIONAL ACADEMY ON AN AGING SOCIETY
3
People who have arthritisuse more health services
The median annual number of physicianvisits is four for those with arthritis, andtwo for those without it. Hospital use is alsogreater for those with arthritis. Some 16 per-cent of those who have arthritis, and 5 per-cent of those who do not, report that theywere hospitalized in the previous year. Aspeople get older, hospital use increases, butdifferences between those with and withoutarthritis remain.Among the population age 70 and older,those with arthritis are more likely to havestayed in nursing homes than those who donot have arthritis. In addition, 94 percent of the elderly with arthritis use prescriptiondrugs, compared to 82 percent of the elder-ly who do not have arthritis. Use of a socialworker, adult day care, rehabilitation, trans-portation, and Meals on Wheels is signifi-cantly higher for the elderly who havearthritis—13 percent—than for those whodo not—7 percent.
The number of Americanswith arthritis is expectedto increase
As the U.S. population ages, the numberof people with arthritis will increase (seeFigure 3).
FIGURE 2
Proportion of Population Reporting Excellent or Very Good Health 
SOURCE
:
National Academy on an Aging Societyanalysis of data from the
1994 National Health Interview Survey.
ALL AGES45 TO 6970+
80706050403020100
   P   E   R   C   E   N   T
WITH ARTHRITISWITHOUT ARTHRITIS
627135344328
AGE
FIGURE 3
Number of People with Arthritis 
SOURCE
:
Centers for Disease Control, 1999
.
1985199019952020
706050403020100
   M   I   L   L   I   O   N   S
35
YEAR
384059

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