Determinants of generalized fatigue in individuals with symptomatic knee osteoarthritis: The MOST Study

Int J Rheum Dis. 2020 Apr;23(4):559-568. doi: 10.1111/1756-185X.13797. Epub 2020 Jan 28.

Abstract

Aim: The aim of the study was to identify sociodemographic, disease-related, physical and mental health-related determinants of fatigue at 2-year follow-up in individuals with symptomatic knee osteoarthritis (OA).

Methods: A longitudinal analysis of participants with symptomatic knee OA from the Multicenter Osteoarthritis Study (MOST) was conducted to identify predictors of fatigue at 2-year follow-up. Participants self-reported fatigue at baseline for the first time in the MOST cohort and at follow-up using a 0-10 visual analog scale. At baseline, questionnaires on sociodemographics, disease-related symptoms, physical and mental health factors were completed. Data were analyzed using linear regressions with a backwards elimination approach.

Results: Of the 2330 individuals in the MOST cohort at baseline, 576 had symptomatic knee OA and of these, 449 with complete fatigue values at baseline and follow-up were included in this analysis. Minimally important fatigue change (ie, worsening [≥1.13], no change [<0.82 or <1.13] and improvement [≥-0.82]) from baseline to follow-up were unequal within the population (34.5%, 26.9%, 38.5%; χ2 [2, N = 449] = 9.32, P = .009). The multiple linear regression showed that baseline fatigue (unstandardized coefficient [Β] = 0.435; 95% confidence interval [CI] 0.348-0.523, P < .001), slow gait speed (Β = -1.124; 95% CI -1.962 to -0.285, P = .009), depressive symptoms (Β = 0.049; 95% CI 0.024-0.075, P < .001) and higher numbers of comorbidities (Β = 0.242; 95% CI 0.045-0.439, P = .016) were significant predictors of greater fatigue at follow-up.

Conclusion: Fatigue is strongly associated with physical- and mental-related health factors. Individualized treatments that include combined psychological and physical function rehabilitation might be modalities for fatigue management.

Keywords: fatigue; knee osteoarthritis; longitudinal; risk factors.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Comorbidity
  • Depression / complications
  • Depression / psychology
  • Fatigue / diagnosis
  • Fatigue / etiology*
  • Fatigue / physiopathology
  • Fatigue / psychology
  • Female
  • Functional Status
  • Gait
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Health
  • Middle Aged
  • Osteoarthritis, Knee / complications*
  • Osteoarthritis, Knee / diagnosis
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / psychology
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • United States