Another reason to exercise for those with arthritis

Washington -- Those interested in maintaining their independence in old age, particularly the millions who have arthritis, should take notice of the findings of a new study and go dancing, hike or climb some stairs.

Lack of regular physical activity was the most prevalent risk factor for functional decline among the 5,715 older men and women with arthritis who were followed for two years by a team of researchers at Northwestern University in Chicago.

Arthritis and chronic joint symptoms affect nearly 70 million Americans, about one in every three adults, making it one of the most prevalent diseases in the United States, according to the Centers for Disease Control and Prevention. And as the population ages, the numbers will increase dramatically.

Although many studies show that physical activity improves health outcomes, the new study, published in the April issue of Arthritis & Rheumatology, goes a step further in finding that it will protect against the progression of disability, said lead author Dorothy D. Dunlop, PhD, research associate professor at the Institute for Health Care Research at Northwestern's Feinberg School of Medicine. "It's a piece of the puzzle that hasn't been well-established."

"The message to patients with arthritis is that they need to get up and get moving. Participating in regular physical activity will help individuals maintain the ability they need to live independently," she said.

So if the prospect of weight loss and stronger muscles doesn't provide enough motivation to push people to make regular exercise a part of their lives, maintaining independence just might do the trick. "The finding that the lack of vigorous physical activity is a strong predictor [for future disability] is very good news from a public health perspective, because it is a modifiable risk factor, and major improvements can be made in people's health by using it as an intervention target," Dr. Dunlop said.

The researchers asked the participants, 65 and older, how frequently they encountered limitations in such daily activities as getting out of bed, bathing and dressing as well as higher level activities such as shopping, using the phone and managing money.

After two years, nearly 14% experienced measurable declines, Dr. Dunlop said. "The toll was somewhat higher in women than in men and was substantially higher among minorities, with 18% of Hispanics and 19% of African-Americans reporting declines in daily task activities."

The researchers found that lack of regular physical activity was the most prevalent risk factor for functional decline among the participants, reported by more than 64% of the subjects. Other than cognitive impairment, which was present in only 3% of the participants, lack of regular vigorous physical activity was the strongest predictor across the spectrum of risk factors examined, including age, education, income level and the toll of other health conditions.

The researchers defined physical activity broadly as exercising three or more times a week, engaging in sports, or heavy housework or other physical labor.

Arthritis remedy

The study was applauded by Patience White, MD, chief public health officer for the Arthritis Foundation, which has long promoted exercise for people with arthritis.

"What we are saying is, 'If you just do something simple that is good for you in many ways -- it keeps your weight down, your heart strong and, by the way, it keeps your joints strong and keeps you from being disabled' -- that's terrific," she said. "A major issue that people have is they don't want to become disabled with arthritis.

"This study shows that with a little activity you can keep your function longer, and I think that's an exciting finding, because many people think there is nothing you can do and that arthritis is just part of getting old."

The CDC has been clear, she said, that walking 30 minutes a day three or four times a week is a very healthy thing to do.

The research also points to a new path for possible pain relief, and it contains a message in the aftermath of the withdrawal of yet another pain-relieving drug from the market, Bextra, that many people with arthritis had used, Dr. White said.

"You can't just let yourself go and hope that there is a medicine at the other end of the rainbow, which seems to be the way a lot of Americans have functioned," she said. "I think we are learning, as we should, that there is a balance to maintain. There is no perfect solution out there, and we have to take some personal responsibility to do things for ourselves when we can."