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Comorbidity in arthritis
Gabriel SE, Crowson CS, O'Fallon WM.. The Journal of rheumatology, 1999-11-01
Topic: Risk, prevention and care in population studies
Objective To describe the relative frequency of selected comorbidities in 2 population based prevalence cohorts of patients with rheumatoid arthritis (RA) and osteoarthritis (OA) compared to age and sex matched community controls. Methods Using the population based data resources of the Rochester Epidemiology Project, we assembled 3 prevalence cohorts of all residents of Olmsted County, Minnesota, with RA (1987 American College of Rheumatology criteria) and age and sex matched controls without arthritis on January 1, 1965, January 1, 1975, and January 1, 1985. Cases and controls were followed longitudinally through their complete (inpatient and outpatient) medical records beginning 10 years prior to the prevalence (or index) date until death, migration from the county, or January 1, 1995. Comorbidity was assessed yearly using the Charlson Comorbidity Index and the Index of Co-existent Diseases (ICED). Descriptive statistics were used to illustrate the baseline characteristics of the study population and the frequency of individual comorbidities in each of the 3 groups over the followup period. Cox proportional hazards modeling was used to assess the risk for each individual comorbidity among patients with arthritis compared to controls and to identify significant predictors of an increase in comorbidity level over time. Results Our study population included 450 RA, 441 OA, and 891 control subjects. The age and sex distributions of cases and their controls were similar. Over the followup period, patients with RA had a higher likelihood of developing congestive heart failure, chronic pulmonary disease, dementia, and peptic ulcer disease, while cases with OA had a significantly higher risk of developing peptic ulcer disease and renal disease. Among patients with either RA or OA, age, male sex, and baseline comorbidity were significant predictors of a rise in comorbidity. The presence of RA was a highly significant predictor of a rise in comorbidity from one year to the next, even after controlling for the effects of age, sex, and baseline comorbidity (p = 0.0004 for the Charlson and p = 0.006 for the ICED). Conclusion These data indicate that the burden of illness among people with arthritis is higher than for nonarthritics and that this burden appears to be increasing over time, particularly in RA. These results suggest that specialized chronic disease care will be increasingly important for the future health care needs of people with RA.
Key findings
- Objective To describe the relative frequency of selected comorbidities in 2 population based prevalence cohorts of patients with rheumatoid arthritis (RA) and osteoarthritis (OA) compared to age and sex matched community controls.
- Cox proportional hazards modeling was used to assess the risk for each individual comorbidity among patients with arthritis compared to controls and to identify significant predictors of an increase in comorbidity level over time.
- Results Our study population included 450 RA, 441 OA, and 891 control subjects.
- Over the followup period, patients with RA had a higher likelihood of developing congestive heart failure, chronic pulmonary disease, dementia, and peptic ulcer disease, while cases with OA had a significantly higher risk of developing peptic ulcer disease and renal disease.
- Among patients with either RA or OA, age, male sex, and baseline comorbidity were significant predictors of a rise in comorbidity.
Why it matters
This study describes the frequency of other medical conditions in people with rheumatoid arthritis and osteoarthritis compared with controls. It does not concern Alzheimer's disease at all and has no implications for treating, curing, or preventing it.
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Study details
- Participants450
- Evidence strengthLow
How this study scored 40/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on journal's citation record, so that was left out: it earned 38 of the 96 points we could judge it on, which is 40 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Journal of rheumatology) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1999 — older than 20 years, still counted |
| Sample size | 2 / 4 | 450 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 101 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.5 citations a year over 29 year(s) since 1999 |
| Impact for its field and year | 1 / 6 | Cited 0.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author O'Fallon Wm: h-index 13 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Mayo Clinic: institution h-index 1,606 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 10555912) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 38 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 38 of the 96 points we could judge it on is 40 out of 100. |
| Total | 40 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. This record has no DOI, so the citation leaves it out. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Gabriel, S. E., Crowson, C. S., & O'Fallon, W. M. (1999). Comorbidity in arthritis. The Journal of rheumatology.
Vancouver
Gabriel SE, Crowson CS, O'Fallon WM. Comorbidity in arthritis. The Journal of rheumatology. 1999. PMID: 10555912.
BibTeX
@article{gabriel1999-10555912,
author = {Gabriel, S. E. and Crowson, C. S. and O'Fallon, W. M.},
title = {{Comorbidity in arthritis}},
journal = {The Journal of rheumatology},
year = {1999},
pmid = {10555912}
}