Epidemiology of the locomotive syndrome: The research on osteoarthritis/osteoporosis against disability study 2005–2015

Abstract

Although locomotive organ disorders are major causes of disability and require support, little information is available regarding their epidemiology. Prevalence and co-existence of locomotive organ disorders including knee osteoarthritis (KOA), lumbar spondylosis (LS), hip osteoarthritis, and osteoporosis have been determined from baseline results of the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) study. KOA, LS, and hip osteoarthritis overlap in the population, while KOA and LS co-exist in 42.0% of people. Mutual associations between locomotive organ disorders, metabolic syndrome components, and mild cognitive impairment were found using baseline and 3-year follow-up data from the ROAD study. Logistic regression analysis showed that hypertension, impaired glucose tolerance, and mild cognitive impairment increase the risk of KOA. Osteoporosis at L2-4 was significantly influenced by the presence of femoral neck osteoporosis, and vice versa. In turn, excess weight was inversely associated with the occurrence of femoral neck osteoporosis. Finally, data from the 3rd survey (7-year follow-up) were used to calculate the prevalence of the locomotive syndrome using tests proposed by the Japanese Orthopaedic Association for assessing the risk of developing locomotive syndrome. Subsequently, the age-sex prevalence of stage 1 and stage 2 locomotive syndrome was estimated at 69.8% and 25.1%, respectively.

Keywords:

• Disability
• Locomotive syndrome
• Metabolic syndrome
• Mild cognitive impairment
• Osteoarthritis
• Osteoporosis

Acknowledgements

Excluding the authors, the results of the following ROAD study investigators are included in this review: Dr. Hiroyuki Oka, Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo; Dr Toru Akune, National Rehabilitation Center for Persons with Disabilities; and Dr. Hiroshi Kawaguchi, JCHO Tokyo Shinjuku Medical Center.

The contributors of the ROAD study shown in the present review were Dr. Hiroyuki Oka (Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo), Dr. Toshiko Iidaka (Department of Joint Disease Research, 22nd Century Medical and Research Center, The University of Tokyo), Dr. Rie Kodama (Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo), Dr. Hiroshi Kawaguchi (JCHO Tokyo Shinjuku Medical Center), and Dr. Toru Akune (National Rehabilitation Center for Persons with Disabilities).

The authors wish to thank Dr. Naoki Hirabayashi of the Kawakami Clinic in Hidakagawa Town; Mrs. Tomoko Takijiri, Mrs. Rie Takiguchi, Mrs. Kyoko Maeda, and other members of the public office in Hidakagawa Town; Mrs. Tamako Tsutsumi, Mrs. Kanami Maeda, Mrs. Megumi Takino, Mrs. Shuko Okada, Mrs. Kazuyo Setoh, Mrs. Chise Ryouno, Mrs. Miki Shimosaki, Mrs. Chika Yamaguchi, Mrs. Yuki Shimoji, and other members of the public office in Taiji Town for their assistance in locating and scheduling participants for examinations. We also thank Ms. Kyoko Yoshimura, Mrs. Toki Sakurai, Mrs. Saeko Sahara, and Mr. Noriyuki Oe for their assistance in data reduction and administration.

Conflict of interest

This work was supported by a Grant-in-Aid H17-Men-eki-009 (Director, Kozo Nakamura), H20-Choujyu-009 (Director, Noriko Yoshimura), H23-Choujyu-002 (Director, Toru Akune), H-25-Choujyu-007 (Director, Noriko Yoshimura), and H25-Nanchitou(Men)-005 (Director, Sakae Tanaka) of the Ministry of Health, Labour and Welfare; and Scientific Research B26293139, B23390172, B20390182, Challenging Exploratory Research 15K15219, 24659317, and Collaborating Research with NSF 08033011-00262 to Noriko Yoshimura; B23390356, C20591774, and Challenging Exploratory Research 23659580 to Shigeyuki Muraki from the Ministry of Education, Culture, Sports, Science and Technology in Japan. This study was also supported by grants from the Japan Osteoporosis Society (Noriko Yoshimura and Shigeyuki Muraki), Japan Osteoporosis Foundation (2015, Noriko Yoshimura), and research aid from the Japanese Orthopaedic Association (JOA-Subsidized Science Project Research 2006-1 & 2010-2; Director, Hiroshi Kawaguchi, 2014-1; Director, Kozo Nakamura).