Impact of comorbidity rates of lumbar spondylosis, knee osteoarthritis, and osteoporosis on physical QOL and risk factors for poor physical QOL in middle-aged and elderly people

Abstract

Purpose: To examine effects of combined osteoporosis (P), knee osteoarthritis (K-OA), and lumbar spondylosis (L-OA) on quality of life (QOL), and identify risk factors for poor QOL.

Methods: 1021 subjects (440 males, 581 females, mean age: 63.4 years) were prospectively included. Osteoporosis (%YAM ≤70%), K-OA (Kellgren-Lawrence grade ≥2), and L-OA (Nathan class ≥3) were defined. Subjects were divided into groups 0 to 3 based on the number of comorbid diseases, and into groups P, K, and L (one disease), PK, PL, and KL (two diseases), and PKL (three diseases). Clinical variables and QOL were compared, and risk factor analysis was conducted.

Results: BMI, muscle strength, pain, and spinal inclination significantly increased and physical QOL worsened with more comorbidities. Though age did not differ among disease groups, BMI was significantly higher in groups K and L than in group P. Groups including subjects with L-OA had significantly lower lumbar lordosis and larger spinal inclination. In multivariate logistic regression analysis adjusted for age and gender, group KL, spinal inclination, gait speed, grip strength, and pain were risk factors for poor physical QOL.

Conclusion: Increased comorbidity has a negative impact on physical QOL, and six risk factors for poor physical QOL were identified.

Keywords:

• Poor quality of life
• lumbar spondylosis
• knee osteoarthritis
• osteoporosis
• positive spinal inclination

Acknowledgments

We are grateful to the staff of the Comprehensive Health Care Program held in Yakumo, Hokkaido, to Mr. Masato Kako and Ms. Azusa Kayamoto in Department of Rehabilitation, Nagoya University Medical School Hospital, and to Ms. Aya Hemmi and Ms. Hiroko Ino in Nagoya University for their assistance throughout this study.

Conflict of interest

None

Additional information

Funding

This study was supported by Japanese Ministry of Health, Labor, and Welfare Grants-in-Aid for Scientific Research (C) (18K09102). No other funds were received in support of this work.