Feasibility of using quadriceps-strengthening exercise to improve pain and sleep in a severely demented elder with osteoarthritis - a case report

Osteoarthritis is positively associated with self-reported sleep trouble in older adults

BACKGROUND

Osteoarthritis (OA) is a leading cause of disability in older adults. Most research has focused on minimizing pain and maximizing physical function so as to maintain patient mobility preceding joint arthroplasty. However, few studies have formally studied the relationship between OA and sleep trouble, although it is clinically recognized that OA may affect sleep.

METHODS

The study was based on the National Health and Nutrition Examination Survey (NHANES) database from 2011-2018. Participants were defined as adults aged 60 years or older with diagnoses of OA and self-reported sleep trouble. Multivariable regression analyses were applied to assess the association between OA and sleep trouble, adjusting for age, sex, body mass index, race/ethnicity, education level, marital status, income, depression level, etc. RESULTS: This study included 4154 participants, consisting of the control group (n = 2966) and the OA group (n = 1188). OA individuals were 2.11 (95% CI 1.79-2.47, p < 0.001) times more likely to have sleep trouble compared with those without OA. On subgroup analyses, there was lower odds ratio value of sleep trouble in men compared with women, and in the highest income group compared with the other income groups.

CONCLUSIONS

OA was positively associated with sleep trouble in older adults, with different odds ratio values among different subgroups. Our results suggest that older adults with OA should be aggressively screened for sleep problems.

Osteoarthritic knee or hip pain: possible indicators in elderly adults with cognitive impairment

Many elderly individuals with cognitive impairment (CI) suffer from chronic pain resulting from osteoarthritis (OA). They have diminished ability to communicate their pain to health care providers, and when pain is undetected, it may be untreated. A method of detecting chronic OA pain in elderly individuals with Cl and measuring treatment outcomes is thus urgently needed. This article examines indicators of chronic OA pain in cognitively intact elderly individuals that could be used to identify pain in elderly individuals with Cl. The review suggests that patients with severe knee or hip OA pain tend to show specific motor patterns, disturbances of gait patterns, and reduction of activity level. Therefore, these behaviors could serve as alternatives to verbal report of chronic pain in elderly individuals with Cl and knee or hip OA.