Arthritis: Aging Population

 
VII.B.4
 

Lead Author(s): 

Beatrice J. Edwards, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

Arthritis is one of the most common chronic conditions found in the US population. It currently affects 54.4 million adults1 and is projected to reach 78.4 million, or 26% of the adult population by 2040.2 Arthritis is the most common cause of disability in the United States and is a major cause of work and activity limitations, which subsequently affects the economy. Pain from arthritis can substantially affect a person’s quality of life.

Self-Reported Arthritis

Arthritis and other rheumatic conditions (AORC) affect people in higher numbers as they age. Only 7 in 100 persons between the ages of 18 and 44 years report they have doctor-diagnosed arthritis. By the age of 65 years and older, this rate has increased to one in two with some form of arthritis. Although the rates of persons reporting limitations in performing activities of daily living are lower, there is a large disparity between younger persons and the aging. (Reference Table 7B.4.1 PDF CSV)

Bed days occur when a person spends at least one-half day in bed in the previous 12 months due to a health condition. On average in the years 2013 to 2015, 607.0 million bed days were reported by persons age 18 years and older due to arthritis. Only 4% of people aged 18 to 44 years reported arthritis-caused bed days. For all people aged 45 years and older, the rate was between 15% and 18%. (Reference Table 7B.4.1 PDF CSV)

Arthritis is most likely to be the cause of lost workdays among people between the ages of 45 and 64 years, with nearly 1 in 10 reporting workdays lost. On average in the years 2013 to 2015, 180.9 million workdays were reported lost due to arthritis, with people in the 45- to 64-year age group accounting for 62% of these days. This higher share of lost workdays for this group is likely due to the much higher participation in the workforce for this prime working age cohort. (Reference Table 7B.4.1 PDF CSV)

Osteoarthritis

The prevalence of clinically diagnosed symptomatic knee osteoarthritis (OA) was calculated from the National Health Interview Survey 2007–2008 and the proportion with advanced disease (Kellgren-Lawrence grades 3–4) was derived using the Osteoarthritis Policy Model, a validated simulation model of knee osteoarthritis. About 14 million persons have symptomatic knee OA, with advanced OA comprising over half of those cases. This includes more than 3 million African American, Hispanic, and other racial/ethnic minorities. Adults under 45 years of age represented nearly 2 million cases of symptomatic knee OA and individuals between 45 and 65 years of age 6 million more.3

Healthcare Visits

Despite the frequency of severe pain often experienced with arthritis and other rheumatic conditions, these illnesses account for only 21% of the nearly 30 million hospital discharges in 2013. Visits to a physician’s office, emergency department, or outpatient clinic account for most healthcare visits related to arthritis and other rheumatic conditions (AORC), with nearly 100 million ambulatory visits in 2013. Among the 6.4 million hospital discharges for an AORC in 2013, age was a factor in increasing rates of hospitalization. Fewer than 1 in 100 persons ages 18 to 44 years had a hospital discharge with a diagnosis of an AORC, while 9 in 100 aged 65 years and older were discharged with an AORC diagnosis. However, among all AORC conditions, the distribution of healthcare visits by age varied by age group. (Reference Table 7B.4.2 PDF CSV)

Osteoarthritis is the primary form of arthritis to affect older persons and begins to show increasing rates for people in their 40s and 50s. Joint pain, the other common problem, results in healthcare visits among people aged 45 to 64.  By the age of 65 years, multiple forms of arthritis are often diagnosed and categorized as other rheumatic conditions. (Reference Table 9B.4.2 PDF CSV)

Age is not a factor in the length of hospital stay or mean charges with a diagnosis of an AORC. In general, the type of AORC is also not a factor in length of stay or charges. Hospital charges are a rough estimate of hospital cost, and do not include doctor’s fees. (Reference Table 9B.4.3 PDF CSV)

Arthroplasty Procedures

Joint replacement procedures are often performed when arthritis has become severe and debilitating. Most procedures are performed on people aged 65 and over, with the exception of spine replacement procedures. (Reference Table 9B.4.4 PDF CSV)

  • 1. Barbour KE, Helmick CG, Boring M, Brady TJ. Vital signs: Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2013-2015. MMWR 2017;66(9):246-253.
  • 2. Hootman JM, Helmick CG. Updated projections of US prevalence of arthritis and associated activity limitations. Arthritis & Rheumatism 2016;68(7):1582-1587.
  • 3. Deshpande BR, Katz JN, Solomon DH, et al. Number of Persons With Symptomatic Knee Osteoarthritis in the US: Impact of Race and Ethnicity, Age, Sex, and Obesity. Arthritis Care & Research 2016;68(12):1743-1750.

Edition: 

  • Fourth Edition

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