Age-specific comorbidity risks in osteoarthritis: implications for healthy aging across diverse populations

Abstract Background Osteoarthritis (OA), a leading cause of disability worldwide, is increasingly recognized for its systemic impact. Despite its prevalence, the age-dependent effects of OA remain underexplored, particularly regarding its association with comorbidities across the life course. Method...

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Main Authors: Lilu Ding, Ruoqi Dai, Dian Jin, Zhanyi Li, Jing Qian, Jiahao Zhu, Jingyou Miao, Hui Zhang, Jing Wang, Yan Xu, Yingjun Li
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Archives of Public Health
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Online Access:https://doi.org/10.1186/s13690-025-01670-9
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author Lilu Ding
Ruoqi Dai
Dian Jin
Zhanyi Li
Jing Qian
Jiahao Zhu
Jingyou Miao
Hui Zhang
Jing Wang
Yan Xu
Yingjun Li
author_facet Lilu Ding
Ruoqi Dai
Dian Jin
Zhanyi Li
Jing Qian
Jiahao Zhu
Jingyou Miao
Hui Zhang
Jing Wang
Yan Xu
Yingjun Li
author_sort Lilu Ding
collection DOAJ
description Abstract Background Osteoarthritis (OA), a leading cause of disability worldwide, is increasingly recognized for its systemic impact. Despite its prevalence, the age-dependent effects of OA remain underexplored, particularly regarding its association with comorbidities across the life course. Methods Using the UK Biobank (78,825 incident OA cases; 301,071 age-/sex-matched controls; age range: 40–86 years) and the CHARLS cohort (China, 5,735 participants, age range: 45–92 years), we employed Cox models with age as the time scale to estimate hazard ratios (HRs) for OA-associated comorbidities, including bone diseases, metabolic disorders, and mental health conditions, stratified by age at diagnosis. Analyses adjusted for sociodemographic factors and population-attributable fractions (PAFs) were calculated to quantify preventable burdens. Results OA was associated with significantly increased risks across multiple comorbidities. All comorbidities exhibited an age-dependent gradient: relative risks were highest in younger individuals and declined with age, while absolute risks increased due to OA’s higher prevalence in older populations. For example, HRs for metabolic disorders declined from 2.55 (95% CI: 2.36–2.76) in those aged 40–49 to 1.77 (95% CI: 1.74–1.81) in those aged ≥ 70. Validation in CHARLS confirmed these patterns. Conclusion The systemic effects of OA vary substantially by age at onset. Younger individuals face elevated proportional risks likely shaped by behavioral, occupational, and structural factors, while older adults bear a larger absolute burden. These findings underscore the need for age-sensitive strategies to reduce long-term health consequences of OA and promote healthy aging. Graphical Abstract
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spelling doaj-art-ac8eef972dae406aaf7f0ccbe6e253e32025-08-20T03:37:28ZengBMCArchives of Public Health2049-32582025-07-0183111110.1186/s13690-025-01670-9Age-specific comorbidity risks in osteoarthritis: implications for healthy aging across diverse populationsLilu Ding0Ruoqi Dai1Dian Jin2Zhanyi Li3Jing Qian4Jiahao Zhu5Jingyou Miao6Hui Zhang7Jing Wang8Yan Xu9Yingjun Li10Department of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical CollegeDepartment of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical CollegeDepartment of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical CollegeDepartment of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical CollegeDepartment of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical CollegeDepartment of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical CollegeDepartment of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical CollegeDepartment of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical CollegeDepartment of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical CollegeZhejiang Provincial Center for Disease Control and PreventionDepartment of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical CollegeAbstract Background Osteoarthritis (OA), a leading cause of disability worldwide, is increasingly recognized for its systemic impact. Despite its prevalence, the age-dependent effects of OA remain underexplored, particularly regarding its association with comorbidities across the life course. Methods Using the UK Biobank (78,825 incident OA cases; 301,071 age-/sex-matched controls; age range: 40–86 years) and the CHARLS cohort (China, 5,735 participants, age range: 45–92 years), we employed Cox models with age as the time scale to estimate hazard ratios (HRs) for OA-associated comorbidities, including bone diseases, metabolic disorders, and mental health conditions, stratified by age at diagnosis. Analyses adjusted for sociodemographic factors and population-attributable fractions (PAFs) were calculated to quantify preventable burdens. Results OA was associated with significantly increased risks across multiple comorbidities. All comorbidities exhibited an age-dependent gradient: relative risks were highest in younger individuals and declined with age, while absolute risks increased due to OA’s higher prevalence in older populations. For example, HRs for metabolic disorders declined from 2.55 (95% CI: 2.36–2.76) in those aged 40–49 to 1.77 (95% CI: 1.74–1.81) in those aged ≥ 70. Validation in CHARLS confirmed these patterns. Conclusion The systemic effects of OA vary substantially by age at onset. Younger individuals face elevated proportional risks likely shaped by behavioral, occupational, and structural factors, while older adults bear a larger absolute burden. These findings underscore the need for age-sensitive strategies to reduce long-term health consequences of OA and promote healthy aging. Graphical Abstracthttps://doi.org/10.1186/s13690-025-01670-9OsteoarthritisComorbiditiesEarly onsetAge-related riskPopulation-based cohort
spellingShingle Lilu Ding
Ruoqi Dai
Dian Jin
Zhanyi Li
Jing Qian
Jiahao Zhu
Jingyou Miao
Hui Zhang
Jing Wang
Yan Xu
Yingjun Li
Age-specific comorbidity risks in osteoarthritis: implications for healthy aging across diverse populations
Archives of Public Health
Osteoarthritis
Comorbidities
Early onset
Age-related risk
Population-based cohort
title Age-specific comorbidity risks in osteoarthritis: implications for healthy aging across diverse populations
title_full Age-specific comorbidity risks in osteoarthritis: implications for healthy aging across diverse populations
title_fullStr Age-specific comorbidity risks in osteoarthritis: implications for healthy aging across diverse populations
title_full_unstemmed Age-specific comorbidity risks in osteoarthritis: implications for healthy aging across diverse populations
title_short Age-specific comorbidity risks in osteoarthritis: implications for healthy aging across diverse populations
title_sort age specific comorbidity risks in osteoarthritis implications for healthy aging across diverse populations
topic Osteoarthritis
Comorbidities
Early onset
Age-related risk
Population-based cohort
url https://doi.org/10.1186/s13690-025-01670-9
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