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. 2024 Aug 22;13(16):4956.
doi: 10.3390/jcm13164956.

Radiographic Knee Osteoarthritis Is a Risk Factor for the Development of Dementia: Locomotive Syndrome and Health Outcomes in the Aizu Cohort Study

Yuji Endo  1 , Hiroshi Kobayashi  1 , Kazuyuki Watanabe  1 , Koji Otani  1 , Kenichi Otoshi  2 , Hironori Numazaki  2 , Miho Sekiguchi  1 , Mari Sato  3 , Takuya Nikaido  1 , Rei Ono  4 , Shin-Ichi Konno  1 , Yoshihiro Matsumoto  1
Affiliations

Radiographic Knee Osteoarthritis Is a Risk Factor for the Development of Dementia: Locomotive Syndrome and Health Outcomes in the Aizu Cohort Study

Yuji Endo et al. J Clin Med. .

Abstract

Objective: Osteoarthritis is linked to dementia, but no longitudinal studies have established this connection. This prospective cohort study from the Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS) aimed to determine if knee osteoarthritis (KOA) independently predicts dementia in adults aged 65 and above.

Methods: Participants were classified by the Kellgren-Laurence scale into no/minimal KOA (grades 0 and I) and definitive KOA (grade II or higher). We analyzed dementia incidence from 2009 to 2015 using long-term care insurance data, adjusting for age, sex, vascular risks, depressive symptoms, and activity levels.

Results: Out of 1089 participants (58.9% female, average age 72.5), 72.0% had definitive KOA. Dementia occurrence was significantly higher in the definitive group (8.4%) compared to the no/minimal group (3.0%) (p < 0.001). A log-rank test and Cox regression analysis confirmed these findings, showing an adjusted hazard ratio of 2.29 (confidence interval: 1.12-4.68) for dementia in those with definitive KOA.

Conclusions: These results suggest that KOA is a significant risk factor for dementia, highlighting the importance of addressing contributing factors in KOA patients to potentially slow the progression of dementia.

Keywords: dementia; knee; osteoarthritis; prospective study.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study cohort from 2009 to 2015, showing initial participant numbers, exclusions, and outcomes. After exclusions for age, knee surgery, and pre-existing conditions, 1089 out of 1113 eligible participants were followed for 6 years, with data on dementia incidence and mortality reported. LOHAS: Locomotive Syndrome and Health Outcomes in the Aizu Cohort Study.
Figure 2
Figure 2
Kaplan–Meier curves illustrating the cumulative incidence of dementia development between the two groups, revealing a significant divergence, as evidenced by a log-rank test (p < 0.001). KOA: Knee osteoarthritis.
Figure 3
Figure 3
Incidence of dementia according to the KL classification. The incidence of dementia increases as the KL grade increases. KL: Kellgren–Laurence classification.
See this image and copyright information in PMC

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