Analysis of an Age-Related Topic: Osteoarthritis

Analysis of an Age-Related Topic: Osteoarthritis The vulnerable nature of the elderly persons subjects them to the risk of various health complications. Fortunately, advancements in health care have improved the care for elderly persons. Elderly persons are now living longer than in the twentieth century. The CDC (2018) has pointed out that effective management of chronic conditions has contributed to improved health for the elderly.

Nevertheless, advancement in healthcare has not alleviated the possibility of developing chronic conditions. The risk of developing chronic conditions is higher among the elderly than young people. This risk is, however, influenced by a variety of factors including the physical activity of the person, diet, and behaviors. Genetic factors and ethnicity are also believed to play a significant role in the development of chronic conditions.

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Arthritis is one of the age-related conditions that affect a large number of elderly persons (Loeser, 2012). This paper will look at various issues related to arthritis including population affected, the cultural, legal and ethical implications. The two most practical interventions for this condition will be highlighted together with their associated costs and sustainability. Some of the community resources for arthritis will also be pointed out.

Definition of the Problem Arthritis is a joint-related condition that affects the elderly. This condition is one of the major causes of disability, pain and the decreased quality of life in the United States and around the world. Statistics have shown that over 54 million people in the U.S suffer from this condition (Arthritis Foundation, 2018). Osteoarthritis, which is the most prevalent form of arthritis among the elderly emanates from injuries as well as the wear and tear of the cartilages on the joints over the years. This condition affects both the major and minor joints in the body. Some of the typical symptoms associated with arthritis include decreased range of motion, joint pain, swelling, and stiffness (Arden & European Society for Clinical and Economic Aspects of Osteoporosis, 2014).

The severity of these symptoms differs from one person to another. Notably, however, these symptoms progress and become severe over time. Patients with chronic pain due to arthritis find it hard to participate in activities of daily living (Rahman & Bagchi, 2013). Patients experience both physical and psychological suffering since this condition affects the self-efficacy and expectations of a person (Hootman, Helmick & Brady, 2012). This condition makes it difficult for the patients to walk or climb stairs. Besides chronic pain, arthritis can also cause damage to

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the joints permanently. At an advanced stage, the condition may have negative effects on the kidneys, the eyes, and the skin of the patient (Loeser, 2012). The impact of arthritis on the elderly population shows there is a need to implement practical prevention and management strategies. The ability to curb the progression of arthritis among older people will have farreaching public health consequences.

Specific Population Affected Even though all ages, sexes and ethnicities can be affected by arthritis, adults form the largest population of those affected. Statistics show that half of the elderly persons above 65 years have arthritis (Obana & Davis, 2016). Notably, however, aging does not cause osteoarthritis, and this condition is not an inevitable outcome of growing old (Loeser, 2012). Not all elderly persons develop this condition. Aging in conjunction with other risk factors promotes the development of arthritis (Hootman et al., 2012). Musculoskeletal changes that occur with aging increase the propensity of this disorder. An important aspect to note is that the risk of developing osteoarthritis is much higher in women than in men, but it is not clear why (Arthritis Foundation, 2018). It is, however, believed that women are predisposed to more risk factors including obesity, inactivity, and poor diet than men.

Cultural Implications Prevalence rates for arthritis vary significantly according to race. However, the reasons for ethnic and racial variations are complex. The overall impact of osteoarthritis is huge for African Americans and other ethnic minorities as compared to mainstream communities.

Behavioral, cultural and socioeconomic factors are believed to contribute to this disparity. Obana and Davis (2016) noted that multiracial groups, African Americans and Hispanics have higher arthritis-attributable activity severe joint pain, and activity limitations than their Caucasian

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counterparts with the disease. The presence of osteoarthritis limits the ability of the patient to perform various roles associated with working, family and social life regardless of the cultural and ethnic background of the patient.

Financial/Legal/Ethical Implications Arthritis has been classified as a huge public health problem due to a large number of people affected. Sørensen, Linde, and Hetland (2014) noted that a large amount of financial resources is used in the care and management of arthritis. It is approximated that in the United States, the total costs for this disorder may exceed 2% of the GDP. To make matters worse, arthritis decreases the ability of a person to participate in economic activities subsequently disrupting the lives of family members (Hootman et al., 2012). Disabilities emanating from arthritis have a huge toll on the family, the health care providers and the government. Over 44 million outpatient visits associated with arthritis are reported every year. This indicates that a substantial amount of money is used in seeking care for arthritis-related complications (Chen, Wang, Wei, Yuce, & Phillips, 2018). Health care providers have a legal and ethical obligation to ensure that elderly persons with arthritis are provided with the best care to alleviate devastating symptoms and improve their quality of life. Furthermore, members of the family and community are required to offer the necessary moral, physical and social support to the elderly with arthritis.

This indicates that the presence of arthritis in an elderly person is not an individual problem, but an issue that affects the whole community.

Interventions Pharmacological strategies and physical activities are the most practical interventions for osteoarthritis. Medications administered in patients with OA are aimed at relieving pain. These medications include Nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen and

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duloxetine (Mayo Clinic, 2018). It is advisable for the patients to comply with the prescriptions since a larger dose of these medications can increase the risk of complications.

Increased physical activity, on the other hand, is aimed at improving the physical activity of the patient (Mayo Clinic, 2018). It involves the development of an exercise program to strengthen the muscles around the joints of the patient, increase the patient’s range of motion, maintain a healthy weight and alleviate joint pain. The two most advisable activities for elderly persons with OA are walking and swimming (Mayo Clinic, 2018). Elderly persons should work with physical therapists to correct their posture and protect the integrity of joints. The physical therapist should train the patient in the best body mechanics during the performance of various physical activities. The patient also needs to be grained on the best mechanics of moving from one position to another in addition to the use of crutches and canes where necessary.

Resources Osteoarthritis Action Alliance, the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the United States Bone and Joint Initiative are some of the national resources for arthritis. These organizations are targeted at improving the care of elderly persons with arthritis and other musculoskeletal disorders. The focus of these entities is to improve the quality of life besides increasing the understanding, prevention and treatment of these conditions. The osteoarthritis action coalition works closely with health care institutions to reduce the burden of arthritis through interventions that address weight management, injury prevention and physical activity. Self-management education has also been proposed as an effective OA management strategy.

Associated Costs

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The cost of care for osteoarthritis increases as the disease progresses to critical stages.

During the early stages of this disease, individuals use a significantly less amount of money in management and prevention activities. However, when the condition progresses to critical stages, the need for complex treatment strategies increases the number of financial resources required.

The cost of pain medications comprises a huge chunk of financial resources required for arthritis.

Studies have revealed that outpatient visits are significantly higher for newly diagnosed patients than those with a long history of this condition (Hootman et al., 2012). The rate of admission increases with advancement in age and disease progression. National and community osteoarthritis resources focus on managing this condition at an early stage to delay its progression to critical stages.

Sustainability Due to the high prevalence among the elderly, osteoarthritis is associated with a significantly high economic burden. The economic burden of this condition indicates there is a need to implement cost-effective treatment and management strategies. The management of OA at an early stage is recommended since it prevents the progressive damage of the joints besides improving the quality of life of patients (Hootman et al., 2012).

Conclusion The vulnerable nature of the elderly persons subjects them to the risk of various health complications. The risk of developing chronic conditions is higher among the elderly than young people. Arthritis is one of the chronic conditions that affect a large number of elderly persons.

Aging in conjunction with other risk factors promotes the development of arthritis.

Musculoskeletal changes that occur with aging increase the propensity of this disorder. Statistics

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show that half of the elderly persons above 65 years have arthritis. The physical, psychological and emotional impact of osteoarthritis is huge for African Americans and other ethnic minorities as compared to mainstream communities. Behavioral, cultural and socioeconomic factors are believed to contribute to this disparity. Pharmacological strategies and physical activities are the most practical interventions for osteoarthritis. Whereas medications help in relieving pain, physical activities strengthen the muscles around the joints of the patient, increase the patient’s range of motion, maintain a healthy weight and alleviate joint pain. Physical therapists should train the patient in the best body mechanics during the performance of various physical activities.

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References Arden, N., & European Society for Clinical and Economic Aspects of Osteoporosis. (2014).

Atlas of osteoarthritis. London: Springer Healthcare Arthritis Foundation (2018). Arthritis facts. Retrieved from https://www.arthritis.org/aboutarthritis/understanding-arthritis/arthritis-statistics-facts.php CDC. (2018). Arthritis. Retrieved from https://www.cdc.gov/arthritis/data_statistics/nationalstatistics.html Chen, C., Wang, L., Wei, W., Yuce, H., & Phillips, K., (2018). Burden of rheumatoid arthritis among US Medicare population: co-morbidities, health-care resource utilization and costs. Rheumatology Advances in Practice, 2(1), i1-i8. https://doi.org/10.1093/rap/rky005 Hootman, J. M., Helmick, C. G., & Brady, T. J. (2012). A public health approach to addressing arthritis in older adults: the most common cause of disability. American Journal of Public Health, 102(3), 426–433. doi: 10.2105/AJPH.2011.300423 Loeser, R. F. (2012). Aging and osteoarthritis. Current Opinion in Rheumatology, 23(5), 492– 496. doi: 10.1097/BOR.0b013e3283494005 Mayo Clinic. (2018). Osteoarthritis. Retrieved from https://www.mayoclinic.org/diseasesconditions/osteoarthritis/diagnosis-treatment/drc-20351930 Obana, K. K., & Davis, J. (2016). Racial disparities in the prevalence of arthritis among Native Hawaiians and Pacific Islanders, Whites, and Asians. Hawaii Journal of Medicine and Public Health, 75(6), 155–161.

Rahman, I., & In Bagchi, D. (2013). Inflammation, advancing age and nutrition: Research and clinical interventions. Amsterdam: Academic Press.

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Sørensen, J., Linde, L., & Hetland, M. L. (2014). Contact frequency, travel time, and travel costs for patients with rheumatoid arthritis. International Journal of Rheumatology, 2014, 1-9. doi: 10.1155/2014/285951