A recent study spanning 20 years revealed that people with osteoarthritis are nearly three times more likely to develop multiple chronic conditions compared to the general population, significantly raising their risk of death. This finding underscores the importance of preventing and managing osteoarthritis progression.
Understanding Osteoarthritis
Osteoarthritis is the most common joint disorder in the United States, particularly affecting middle-aged and older adults. Beyond its immediate symptoms of joint pain and stiffness that diminish quality of life, it frequently occurs alongside other serious chronic conditions, including cardiovascular disease, dementia, and diabetes.
In 2011, Stanford University published a study in Nature Medicine identifying low-grade chronic inflammation as a key driver of osteoarthritis progression. This inflammatory mechanism is similar to those found in other degenerative diseases like Alzheimer’s and macular degeneration, and creates links to conditions such as cardiovascular disease, diabetes, and cancer.
The Cascade Effect of Chronic Conditions
Recent research provides some evidence of the interconnected nature of osteoarthritis and other health condition and excess weight, obesity, and physical inactivity are shared risk factors.
Increased Risk of Chronic Conditions
A study published in RMD Open in July followed nearly 10,000 osteoarthritis patients (average age 66) over two decades. The findings showed that these patients were three times more likely to develop severe multimorbidity (having two or more chronic health conditions) compared to those without osteoarthritis, which in turn increased their risk of death. By the study’s end, 57 percent of patients had died.
Patients with severe multimorbidity typically developed about 10 chronic conditions, most commonly:
- Cardiovascular disease
- Cancer
- Diabetes
- Chronic obstructive pulmonary disease (COPD)
- Inflammatory bowel disease (IBD)
- Cataracts
The study also highlighted that osteoarthritis accelerates the progression of other chronic conditions, leading to rapid health deterioration.
An earlier study based on clinical data from general practitioners in the UK found that 96 percent of more than 1,000 osteoarthritis patients had at least one comorbidity, with the combined impact of multiple conditions creating greater disability than individual conditions alone, resulting in poorer physical functioning in these patients.
A 2019 meta-analysis of 42 studies revealed that more than two-thirds (67 percent) of osteoarthritis patients had at least one other chronic condition—20 percent higher than in those without osteoarthritis.
The most common additional conditions were:
- Stroke (1.6 times higher risk)
- Peptic ulcers (1.4 times higher risk)
- Metabolic syndrome (0.9 times higher risk)
Increased Risk of Cardiovascular Disease
In a 2023 study published in Scientific Reports, over 200,000 people were followed for six years. The results showed that knee osteoarthritis patients had:
- 26 percent higher overall cardiovascular disease risk
- 20 percent higher heart attack risk
- 29 percent higher stroke risk
A separate systematic review of over 32 million people, published in 2020 in the European Journal of Preventive Cardiology, found osteoarthritis patients had:
- 2.8 times higher risk of heart failure
- 1.8 times higher risk of ischemic heart disease
Increased Risk of Dementia
Multiple studies have established osteoarthritis as an independent risk factor for dementia, meaning that osteoarthritis patients are at a higher risk of developing dementia.
A 2021 cohort study of 17,000 adults in the United States, all 65 and older, found that osteoarthritis and its associated pain increased the risk of Alzheimer’s disease and related dementias by 31 percent.
These findings are consistent with a 2015 study involving 35,000 osteoarthritis patients in Taiwan, which showed a 25 percent higher risk of developing dementia potentially due to impaired physical activity, osteoarthritis-induced inflammation, and associated depression.
A recent study on the mechanisms of osteoarthritis, published in Science Translational Medicine, identified a shared protein that contributes to both joint cartilage damage and dementia risk.
Increased Risk of Diabetes
Osteoarthritis and Type 2 diabetes are two chronic diseases that frequently occur together. They share common risk factors, including aging, obesity, and physical inactivity, as well as similar underlying mechanisms, such as inflammation, oxidative stress, and endothelial dysfunction (when the lining of the blood vessels doesn’t work properly).
A cohort study of 16,000 osteoarthritis patients in Canada found a 16-25 percent increased diabetes risk.
A meta-analysis of 1.04 million people showed that osteoarthritis patients had a 41 percent higher risk of developing diabetes compared to non-patients and that diabetes patients were 46 percent more likely to develop osteoarthritis than those without diabetes.
Increased Risk of Death from Complications
Osteoarthritis patients have a higher risk of death.
A 2018 study conducted in the United States tracking more than 50,000 osteoarthritis patients found increased death risks from:
- Cardiovascular disease (43 percent higher)
- Diabetes (104 percent higher)
The risk of death from these conditions was even greater among obese osteoarthritis patients—89 percent higher for cardiovascular disease and 242 percent higher for diabetes. Among those diagnosed before the age of 40, the risk of death from diabetes surged by 618 percent.
A 2011 study also indicated that all-cause mortality among osteoarthritis patients was 55 percent higher than in the general population, with increased risks for:
- Cardiovascular disease (71 percent)
- Dementia (99 percent)
- Diabetes (95 percent)
- Cancer (128 percent)
Additionally, the more severe the walking disability caused by osteoarthritis, the greater the risk of mortality.
Prevention and Management Strategies
While clinical trials are exploring the use of stem cells and exosomes to treat osteoarthritis and other degenerative diseases, current medical practice still focuses on preventing and slowing disease progression. Obesity, physical inactivity, and chronic inflammation are common risk factors for conditions like osteoarthritis, diabetes, and cardiovascular disease, making it essential to address and prevent them.
Regular exercise and a healthy diet can support weight loss and help reduce chronic inflammation, thereby improving overall metabolic function and strengthening immunity.
Weight loss is an effective way to prevent and slow the progression of osteoarthritis. More than 20 percent of osteoarthritis cases are linked to excess weight. Additionally, the knee joint is the most commonly affected area, and excess body weight places extra strain on the knees, worsening the condition and intensifying the pain. A 2005 study found that for every pound of weight lost, the load on the knee joint decreased by approximately four-fold.
Regular exercise can strengthen the muscles around the joints, reduce joint pressure, and stimulate the secretion of fluid to lubricate the joints, according to Kuo-Pin Wu, superintendent of Taiwan Xinyitang Heart Clinic. Low-impact activities such as walking, swimming, and tai chi are ideal for patients with osteoarthritis, according to Wu.
People with osteoarthritis should avoid high-impact or injury-prone movements such as jumping, twisting, and weight training. It is also important to maintain a steady pace during daily activities and take adequate rest when feeling fatigued to avoid joint damage, according to Wu.
Wu shared five simple home exercises that can effectively relieve joint stiffness and pain.
In terms of diet, he recommends increasing the intake of foods with anti-inflammatory and anti-aging properties, such as:
- Fruits and vegetables: Blueberries, strawberries, tomatoes, bell peppers, and broccoli are rich in antioxidants that help neutralize free radicals in the body.
- Nuts: Walnuts, pistachios, and almonds are high in dietary fiber and unsaturated fatty acids, offering both anti-inflammatory and antioxidant benefits.
- Fish: Salmon, sardines, and tuna are excellent sources of omega-3 fatty acids, which provide anti-inflammatory benefits.
- Whole grains: Whole wheat bread and legumes are rich in dietary fiber, which can aid in weight loss and reduce inflammation, thereby preventing and managing osteoarthritis.