Abstract
This retrospective
study explored the correlation between joint osteophyte severity and natural
aging and evaluated age-appropriate nursing interventions in 30 patients with
joint osteophytes. Patients were stratified into middle-aged group (45-64
years, n=15) and elderly group (≥65 years, n=15), with each group divided into
intervention (n=8) and control (n=7) subgroups. Intervention subgroups received
age-appropriate nursing (adjusted exercise intensity, multimorbidity
management, geriatric syndrome prevention), while controls received routine
care. Primary outcomes included correlation between age and osteophyte severity
(Larsen grade) and change in Lequesne Index at 6 months. Results showed
significant positive correlation between age and initial Larsen grade (r=0.67,
p<0.01). Intervention subgroups in both age strata demonstrated greater
improvement in Lequesne Index (middle-aged: 12.5±3.2 vs 6.8±2.7; elderly:
10.3±2.9 vs 5.1±2.3, p<0.01 for both). Age-appropriate nursing interventions
effectively improve outcomes in age-related joint osteophytes, with tailored
strategies addressing age-specific physiological changes.
Keywords: Osteoarthrosis; Larsen grade; Geriatric syndrome
prevention; Lequesne index
Introduction
Natural aging is the
strongest non-modifiable risk factor for joint osteophytes, with prevalence
increasing from 15% in adults <50 years to 70% in those ≥70 years1. Age-related changes (chondrocyte senescence,
extracellular matrix degradation and reduced periarticular muscle mass)
accelerate osteophyte formation and progression2. This study investigates the age-osteophyte
correlation and evaluates nursing interventions tailored to different age
groups, addressing the lack of age-stratified nursing protocols3.
Methods
Study design and
participants
Retrospective analysis of 30 patients with
radiographically confirmed joint osteophytes (knee: 21 cases, hip: 9 cases).
Inclusion criteria: age 45-85 years; Larsen grade I-IV osteophytes; no history
of joint trauma or inflammatory arthritis. Exclusion criteria: metabolic bone
diseases, joint surgery history and cognitive impairment precluding
intervention compliance.
Grouping & interventions
Control subgroups: Routine care (pain
assessment, general mobility advice).
Intervention subgroups:
Age-appropriate interventions:
• Middle-aged group: Moderate-intensity resistance training (3x/week), workplace ergonomics guidance and metabolic risk factor control (weight/BMI monitoring).
• Elderly group: Low-impact aquatic exercise, fall prevention programs, polypharmacy review (to avoid drug-induced myopathy) and sarcopenia screening with protein supplementation.
• Both groups: Joint protection education, progressive activity pacing and symptom self-management training.
Outcome measures
• Primary: Correlation between age and initial Larsen grade; change in Lequesne Index (0-24, higher=worse) at 6 months.
• Secondary: Muscle strength (handheld dynamometry), Timed Up and Go (TUG) test and geriatric nutritional risk index (GNRI) in elderly subgroup.
Statistical analysis
SPSS 26.0 used for
Pearson correlation, independent t-tests and two-way ANOVA. p<0.05 was
significant.
Results
Age-osteophyte correlation and baseline data
Significant positive
correlation between age and initial Larsen grade (r=0.67, p<0.01). No
significant differences in baseline characteristics within age strata (Table
1).
Table 1: Baseline
Characteristics by Age Group
|
Characteristics |
Middle-aged (45-64y, n=15) |
Elderly (≥65y, n=15) |
p-value |
|
Mean age (years) |
56.3±7.2 |
72.5±6.8 |
<0.001 |
|
Male gender, n(%) |
9(60.0) |
7(46.7) |
0.45 |
|
Affected joint (knee/hip) |
11/4 |
10/5 |
0.82 |
|
Initial Larsen grade |
1.8±0.6 |
2.9±0.8 |
<0.001 |
|
Initial Lequesne Index |
18.2±4.1 |
21.5±3.8 |
0.012 |
|
Muscle strength (kg) |
27.5±5.3 |
20.8±4.6 |
<0.001 |
Greater improvement in
Lequesne Index in intervention subgroups across both age groups (Table 2).
Table 2: Change in Lequesne
Index at 6 Months
|
Group |
n |
Baseline |
6 Months |
Change (mean±SD) |
p-value |
|
Middle-aged Intervention |
8 |
17.8±3.9 |
5.3±2.1 |
12.5±3.2 |
<0.001 |
|
Middle-aged Control |
7 |
18.6±4.2 |
11.8±3.1 |
6.8±2.7 |
- |
|
Elderly Intervention |
8 |
21.2±3.7 |
10.9±2.8 |
10.3±2.9 |
<0.001 |
|
Elderly Control |
7 |
21.8±4.0 |
16.7±3.5 |
5.1±2.3 |
- |
Secondary outcomes
Intervention subgroups
showed significant improvements in muscle strength and TUG test, with elderly
intervention subgroup demonstrating higher GNRI (Table 3).
Table 3: Secondary Outcomes at
6 Months
|
Outcome |
Middle-aged Group |
Elderly Group |
p-value (intervention effect) |
|
Muscle strength (kg) |
Intervention:32.6±4.8 |
Intervention:24.5±4.1 |
<0.001 |
|
|
Control:28.1±5.2 |
Control:21.2±3.9 |
- |
|
TUG test (sec) |
Intervention:8.2±1.5 |
Intervention:11.3±2.1 |
<0.001 |
|
|
Control:10.5±2.0 |
Control:15.7±2.8 |
- |
|
GNRI (elderly only) |
- |
Intervention:98.6±5.3 |
0.002 |
|
|
- |
Control:90.2±6.7 |
- |
Discussion
This study confirms
a strong positive correlation between natural aging and osteophyte severity,
consistent with age-related chondrocyte senescence and matrix degradation
mechanisms4. The 61% higher Larsen grade in the elderly group
aligns with epidemiological data showing exponential osteophyte progression
after 65 years5.
Age-appropriate
interventions addressed key age-specific factors: middle-aged patients
benefited from resistance training to counter early muscle loss, while elderly
patients required low-impact exercise to balance mobility and fall risk6. Polypharmacy
review in the elderly subgroup reduced use of medications (e.g., long-term
glucocorticoids) that exacerbate muscle weakness and joint degeneration7.
Notably, the elderly
intervention subgroup showed significant GNRI improvement, highlighting the
role of nutrition in maintaining musculoskeletal health during aging-a factor
often overlooked in standard osteophyte care8. The smaller
absolute improvement in the elderly group reflects irreversible age-related
changes, emphasizing the importance of early intervention.
Limitations include
small sample size and lack of histopathological confirmation of age-related
chondrocyte changes. Future studies should incorporate biomarkers of cellular
senescence to better quantify the aging-osteophyte relationship.
Conclusion
Joint osteophyte severity
correlates significantly with natural aging. Age-appropriate nursing
interventions effectively improve functional outcomes by addressing
age-specific physiological changes (muscle loss, multimorbidity, nutritional
decline). These strategies should be integrated into nursing care to optimize
outcomes across the age spectrum.
References