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How Does Age Affect People's Experiences Of OA?30th May 2019
When we think about arthritis, there is a tendency to categorise it as an old person’s disease. We envision the little old lady struggling to make it across the road or the old man with a walking stick. But the reality couldn’t be further from the truth. There are thought to be around 10 million people living in the UK with the disease and these cover a range of ages from children right up to those over the age of 65.
Some specific types of arthritis, such as Ankylosing Spondylitis affect those in younger age brackets, being more prevalent in people aged 16-34 than in any other age category. Then there is Juvenile Arthritis, which as the name suggests, affects children only. Thankfully two in three of the children with this illness will recover by adulthood. But that third child can expect a very painful life, having to make changes in their daily routine due to a lack of mobility and social interaction.
What is Osteoarthritis?
Osteoarthritis, or OA for short is a specific type of arthritis which presents itself as joint pain and stiffness. It can affect any joint in the body, but those which are particularly prone are the knees, hips and hands. It is caused by general wear and tear on the joints and cartilage over the years. In everyday life, our joints experience low-level damage. While the damage is usually repaired by our bodies and no symptoms present themselves, osteoarthritis is caused when the body is unable to repair itself successfully. The cartilage which covers the end of our bones breaks down which can cause swelling, pain and difficulty moving the joint. You may also develop bony growths which can add extra pressure and cause additional pain and inflammation.
What Causes Osteoarthritis?
While scientists remain unsure as to what causes osteoarthritis to develop, there are some known markers which increase the risk of developing OA. The first of these is obesity, which can put undue pressure on the joints. Remember that joints already experience low-level damage every day. Adding extra weight to the joints only increases this damage and therefore makes OA more likely, particularly in those that have had a lifetime of obesity. Coggon et al found that subjects with a BMI of 30kg/m₂ or above (a BMI of 30 or more) were 6.8 times more likely to develop knee OA than those with normal weights.
Joint injury can also make you more prone to the disease. This is known as post-traumatic osteoarthritis. Post-traumatic arthritis can be caused by a sports injury, car accident or an injury at work. This can cause cartilage or bone damage which can change the mechanics of the joint. Further injuries or continued use of the joint, for example, through walking, will cause inflammation and fluid accumulation in the joint which may increase as it is subjected to further movement.
There are a number of things you can do to minimise the possibility of joint injury during exercise. Warming up before any exercise is one of the most important considerations, particularly if you are exercising or playing sports outdoors.
Your family history also gives a little insight into whether you’re more likely to have OA during your lifetime. It’s thought that those with close family members who have the disease are more likely to develop OA. However, there is currently no research which specifies which gene is responsible for osteoarthritis. It is believed that females are more likely to suffer from OA than males, with knee osteoarthritis the most common area of complaint. Despite this, females are believed to be three times less likely to undergo hip or knee arthroplasty (O’Connor, MI 2007) to repair the damage done by osteoarthritis. When reviewing statistics it’s believed that females are more likely to have most types of arthritis, with the exception of gout, which is skewed towards males.
Is Age a Factor?
RF Loeser states that osteoarthritis is the most common cause of chronic disability in older adults (Loeser, 2011). But while osteoarthritis is common in older people, it is not necessarily caused by old age. After all, many younger people have had diagnoses of arthritis. However, when age is combined with one or more of the risk factors listed above, particularly obesity, we see an overall increase in the chances of developing osteoarthritis.
So how does age factor into the equation? Osteoarthritis is believed to be caused, at least in part, through the repeated use of joints. Osteoarthritis is caused by wear and tear, so it makes sense that those who are older are more prone to having the disease since, theoretically, their joints are likely to have seen greater use.
As we age, we lose muscle mass and gain fat, which can also cause excess strain on our joints as we move, and with it increase the risk of damage to hips, knees and ankles. This adipose tissue is also known to carry inflammatory mediators known as adipokines, which are believed to negatively affect body joints.
Joints come under particular strain during exercise, with almost all of your synovial joints coming into use during exertion. But while the strain can cause pain if a joint is not correctly supported, exercise can, in fact, increase the protective properties of synovial joint fluid, meaning exercise can be a key treatment in managing pain from arthritis. Studies have found that women who exercise experience an increase in anti-inflammatory substances surrounding the joints after exercise, compared to lower levels for those who remain sedentary.
Knees are one of the most common areas to become inflamed with age and support can be given during day to day activities or when exercising using a knee wrap or brace. In many cases, knee wraps will include patella support, with a cut-out area positioned on the kneecap to hold it firmly in position. For moderate injuries or weakness remaining from ligament damage, a knee brace may be necessary. These can be fitted specifically to your measurements in order to ensure a perfect fit that offers optimum support. These are made from a flexible, breathable material on the inside and a rigid material on the outside which is hinged at the knee to track movement. Immobilisers can also be used to restrict movement following knee surgery. These cannot be used during exercise.
But as we all know, as we age our cells repair at a slower rate. This reduced repair rate is one of the biggest contributors to age-related body damage. The cells in cartilage, known as chondrocytes in adults, are less responsive to growth factor stimulation, meaning that damage in the cell remains for longer. Cartilage cells struggle to detoxify, which can cause problems with cells replicating and lead to possible cell death.
While little can be done to minimise cell death, we can reduce inflammation in our joints in part, by eating a balanced diet that’s rich in foods with anti-inflammatory properties. Arthritis.org has detailed information on its website which outlines a healthy diet, but we recommend including dark, leafy vegetables which have a generous helping of vitamins A, C and K which are antioxidants and calcium, which can help preserve bone structure. Omega 3 is also thought to help joint flexibility, so eating oily fish or taking an Omega 3 supplement may also help you maintain joint health into the future.