Sociological Risk Factors in the Development of Knee Osteoarthritis among Women > 50 years Case-Control Study


Background: Osteoarthritis is now firmly established as a public health problem. It is the most disabling diseases in many countries. Knee osteoarthritis is regarded as the most common form of the disease in adult. Elderly women are found to be more affected by this disorder. From the available evidences, it is now reasonable to consider this disease as one of the most important among the chronic non-communicable diseases and investigation for the risk factors that are associated with this disorder is very important. Aim: To examine sociological risk factors in the development of symptomatic knee osteoarthritis for women > 50 years. Study design: Case-control study, where 76 women with symptomatic knee osteoarthritis proved by clinical and radiological evidences were allocated as cases. Another 116 women proved to be without clinical or radiological evidence of knee osteoarthritis was allocated as controls. Study period: 1st March 2007 to 1st December 2007.Questionnaire: Including, assessment of sociological factors such as personal characteristics (social identity, personal habits and psychological make-up), life events (stress, social discontinuities and geographical mobility) and social context (economic factors, social disintegration, urbanization). In addition, body mass index, previous history of surgical operation, the use of contraceptive pills and the presence of one or more of chronic non-communicable diseases, were also gained. Results: Regarding Personal Characteristics; unhealthy dietary behaviors appeared in this study to be highly associated with development of knee OA (OR= 7.19, P-value= 0.001, 95%C.I. = 2.08-18.60), the same thing was applied to women with personality type A (OR= 2.84, P-value= 0.009, 95% C.I. = 1.29-6.23). The habit of cigarette smoking appeared unexpectedly negatively associated with occurrence of knee OA (OR= 0.41, P-value=0.035 and 95%C.I. = 0.18-0.94). According to Life Events; stress was negatively associated with the development of knee OA (OR=0.24, p-value= 0.002, 95%C.I. = 0.10-0.59). The geographical mobility appears in this table to be protective against the development of knee OA (OR= 0.15, P-value= 0.000, 95%C.I. = 0.07-0.31). Dramatic change in economic factor, appeared to be negatively highly associated with the development of knee OA (OR= 0.12, P-value= 0.000, 95%C.I. = 0.04-0.34). Urban citizens, in this study appeared to be more prone to develop knee OA than rural citizens (OR= 3.04, P-value= 0.017, 95%C.I. = 1.22-7.57). General obesity (BMI > 25) is valid predictor for the development of knee OA (OR= 8.88, P-value= 0.000, 95%C.I. = 3.08-25.60). The presence of one or more of chronic non-communicable diseases appear to be associated with the occurrence of knee OA (OR=2.60, P-value=0.002, 95% C.I. = 1.43-4.72). Contraceptive pills users among women appear to be associated with the development of knee OA (OR= 3.21, P-value= 0.0001, 95%C.I. = 1.64-5.94). Conclusion: Women with unhealthy dietary behavior, personality type urbanization, general obesity, with one or more of chronic non-communicable diseases and contraceptive pills users are at high risk of development of knee OA. Cigarette smoking, stress, geographical motilities and unexpected change in economic status appeared to be negatively associated with the occurrence of knee OA in women > 50 years.Key words: Sociological risk factors, Knee, Osteoarthritis, Women, > 50 years.