Abstract
This retrospective
study explored the correlation between osteoarthrosis severity and natural
aging and evaluated age-tailored nursing interventions in 40 patients with
osteoarthrosis. Patients were stratified into middle-aged group (45-64 years,
n=20) and elderly group (≥65 years, n=20), with each group divided into
intervention (n=11) and control (n=9) subgroups. Intervention subgroups
received age-tailored nursing (adjusted exercise intensity, multimorbidity
management, geriatric syndrome prevention), while controls received routine
care. Primary outcomes included correlation between age and osteoarthrosis
severity (Kellgren-Lawrence grade) and change in Lequesne Index at 6 months.
Results showed significant positive correlation between age and initial Kellgren-Lawrence
grade (r=0.69, p<0.01). Intervention subgroups in both age strata
demonstrated greater improvement in Lequesne Index (middle-aged: 11.8±3.1 vs
6.2±2.5; elderly: 10.5±2.8 vs 4.9±2.2, p<0.01 for both). Age-tailored
nursing interventions effectively improve outcomes in age-related
osteoarthrosis, with tailored strategies addressing age-specific physiological
changes.
Keywords: Osteoarthrosis; Larsen grade; Kellgren-lawrence grade;
Lequesne index
Introduction
Natural aging is the
strongest non-modifiable risk factor for osteoarthrosis, with prevalence
increasing from 12% in adults <50 years to 68% in those ≥70 years1. Age-related changes (chondrocyte senescence,
extracellular matrix degradation and reduced periarticular muscle mass)
accelerate osteoarthrosis progression2. This study investigates the age-osteoarthrosis
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 40 patients with
radiographically confirmed osteoarthrosis (knee: 28 cases, hip: 12 cases).
Inclusion criteria: age 45-85 years; Kellgren-Lawrence grade I-IV; 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-tailored 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 Kellgren-Lawrence 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-osteoarthrosis correlation and baseline data
Significant positive
correlation between age and initial Kellgren-Lawrence grade (r=0.69,
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=20) |
Elderly (≥65y, n=20) |
p-value |
|
Mean age (years) |
57.2±7.5 |
73.1±6.9 |
<0.001 |
|
Male gender, n(%) |
11(55.0) |
10(50.0) |
0.76 |
|
Affected joint (knee/hip) |
15/5 |
13/7 |
0.62 |
|
Initial Kellgren-Lawrence grade |
1.9±0.7 |
3.0±0.8 |
<0.001 |
|
Initial Lequesne Index |
17.8±4.0 |
21.9±3.7 |
0.009 |
|
Muscle strength (kg) |
27.8±5.1 |
20.5±4.3 |
<0.001 |
Primary outcome
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 |
11 |
17.5±3.8 |
5.7±2.3 |
11.8±3.1 |
<0.001 |
|
Middle-aged Control |
9 |
18.1±4.2 |
11.9±3.0 |
6.2±2.5 |
- |
|
Elderly Intervention |
11 |
21.6±3.6 |
11.1±2.9 |
10.5±2.8 |
<0.001 |
|
Elderly Control |
9 |
22.2±3.9 |
17.3±3.4 |
4.9±2.2 |
- |
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:32.9±4.6 |
Intervention:24.2±4.0 |
<0.001 |
|
|
Control:28.3±5.0 |
Control:21.0±3.7 |
- |
|
TUG test (sec) |
Intervention:8.1±1.4 |
Intervention:11.1±2.0 |
<0.001 |
|
|
Control:10.3±1.9 |
Control:15.5±2.6 |
- |
|
GNRI (elderly only) |
- |
Intervention:98.3±5.1 |
0.003 |
|
|
- |
Control:89.8±6.5 |
- |
Discussion
This study confirms
a strong positive correlation between natural aging and osteoarthrosis
severity, consistent with age-related chondrocyte senescence and matrix
degradation mechanisms4. The 57.9% higher Kellgren-Lawrence grade in
the elderly group aligns with epidemiological data showing exponential
osteoarthrosis progression after 65 years5.
Age-tailored 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 osteoarthrosis 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-osteoarthrosis relationship.
Conclusion
Osteoarthrosis severity
correlates significantly with natural aging. Age-tailored 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