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Obesity, Aging Tied to Spike in Arthritis

CDC reports 750,000 new cases yearly since 1990

THURSDAY, May 3 (HealthScout) -- The number of people who say they have arthritis has increased by almost 750,000 each year since 1990, the government reports.

About 43.1 million Americans of every age said they had arthritis in 1997, while another 7.9 million reported the disease was affecting their daily lives, according to a Centers for Disease Control and Prevention (CDC) report. By 2020, some 60 million men and women are expected to be affected by arthritis, the agency adds, with 11.9 million suffering from activity limitations.

"The population's graying and there's more arthritis, to the tune of about three-quarters of a million people each year," says Dr. Jeffrey Sacks, a medical epidemiologist with the CDC. "And since obesity is a risk factor for arthritis and we are in the midst of an epidemic of obesity, and the lack of physical activity is tied to obesity, they are both reasons for the increase in the disease in this country."

Women are bearing the brunt of the problem, the CDC report suggests. About 26.8 million women reported having arthritis compared to 16.4 million men, and women were twice as likely as men to report that arthritis limited their activities.

Arthritis is the leading cause of disability in the U.S., estimated to cost almost $65 billion each year in medical care and lost productivity. There are over 100 types of arthritis blamed for the pain, stiffness, and occasional swelling of joints that can limit movement and make life miserable. What causes arthritis is not completely understood, though researchers are delving into whether genetic factors and lifestyle are at the root of the disease.

The CDC has changed the way it reports arthritis, Sacks explains. "What usually happens is that you hand a person a list of conditions in which arthritis is listed and you ask them to report if they have one of the diseases," he says. "But since many people with symptoms of arthritis don't go to a doctor and therefore don't necessarily have a diagnosis, they don't necessarily say yes, they have arthritis."

In 1997, the CDC "started asking questions about symptoms of arthritis, which will better identify people who have the disease in the future," Sacks says.

The findings were published in the May 4 Morbidity and Mortality Weekly Report.

While most of the increase in arthritis can be attributed to an aging population, "a larger proportion of us are heavier, and that is driving the numbers," agrees Edward Yelin, a professor of medicine and health policy at the University of California, San Francisco. "It seems that at every age more of us are heavier, and at every age there is an increase in arthritis," he adds.

And women may be more prone to arthritis because they live longer than men do, Yelin suggests. "Men more commonly get fatal chronic diseases like cardiovascular disease and women are more likely to get non-fatal chronic diseases like arthritis. In part what may be happening, at more advanced ages the men are gone, and by dying, they avoid the onset of arthritis or suffering from it."

Effective interventions for arthritis are available, Sacks says. "We do know a lot about preventing arthritis. Maintaining an ideal body weight and being physically active while trying not to sustain injury to the joints is the best strategy."

Go to the doctor if your joints are stiff, Sacks advises. "If people develop symptoms, early diagnosis prevents a lot of the disability that can occur. Most people don't seek medical evaluation because there's a fallacy that it's a normal part of aging, and a few aspirin is the only thing you can do."

But early diagnosis prevents progression of the disease, Sacks says. "There are special exercises, range-of-motion programs and educational programs on self-management of the disease that we know are effective."

What To Do

Get up and go while you can. Inactivity has many bad effects, and now you can add arthritis to the list. But try not to hurt yourself, since injuries are another risk factor for arthritis.

For more information on arthritis, visit the Arthritis Foundation or Johns Hopkins University.

And try these HealthScout stories on arthritis.

SOURCES: Interviews with Jeffrey Sacks, M.D., M.P.H., medical epidemiologist, Centers for Disease Control and Prevention, Atlanta, and Edward Yelin, Ph.D., professor of medicine and health policy, University of California, San Francisco; May 4, 2001 Morbidity and Mortality Weekly Report
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