Relationships between pain, physical activity and sleep quality among older adults with radiographic knee osteoarthritis: findings from the Hertfordshire Cohort Study

Abstract

Aims: To determine if the relationship between joint pain and sleep quality among individuals with osteoarthritis (OA) differs according to physical activity level among older adults. Methods: 169 community-dwelling older adults in the UK Hertfordshire Cohort Study (aged 71–80) with radiographic knee OA completed a questionnaire. This included: the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); the Pittsburgh Sleep Quality Index (PSQI); the Longitudinal Aging Study Amsterdam Physical Activity Questionnaire; and the Hospital Anxiety and Depression (HAD) Scale. Logistic regression was used to examine the WOMAC knee pain score in relation to having poor sleep quality (PSQI > 5) with adjustment for sex, age, and anxiety and depression scores; analyses were performed with and without stratification by physical activity category (bottom sex-specific tertile vs. not). Results: Knee pain prevalence (WOMAC pain score > 0) was 40.7% among men and 46.6% among women; 37.0% of men and 50.0% of women reported poor sleep quality (PSQI > 5). Higher WOMAC pain scores were related to increased risk of poor sleep quality; odds ratio (95% CI) per unit increase in pain score: 1.15 (1.01,1.32), p = 0.038). Relationships were similar across physical activity levels. Conclusions: Relationships between joint pain and poor sleep quality among older adults with radiographic knee OA were similar, regardless of physical activity level. Our results highlight the high prevalence of both sleep disturbance and significant knee pain in this group, illustrating the need to consider supportive measures as appropriate in this population.