People with arthritis who report more negative feelings about how they are aging tend to get less physical activity and perceive themselves as less healthy, according to a new study by researchers at Hospital for Special Surgery (HSS) and Weill Cornell Medicine. However, self-perception of good health explained the effect of negative thinking – providing an opportunity for clinicians to focus on a patient’s outlook on aging as well as their overall health.

“Physical activity is essential for older adults with arthritis, as it can help to reduce pain and stiffness, improve mobility, and maintain independence,” said Sarah B. Lieber, MD, MS, a rheumatologist at HSS and leader of the study. “However, many older adults with arthritis do not get recommended levels of physical activity. Our study suggests that self-perceptions of aging and general health may at least partly explain why.”

For clinicians, the new study could serve as a conversation starter with older patients, Dr. Lieber says. “I think this study and others like it can help doctors begin or continue a discussion with their patients about the factors that may challenge them to be physically active.”

Dr. Lieber and her colleagues presented their findings at the 2023 ACR Convergence meeting of the American College of Rheumatology, held November 10 to 15 in San Diego.

The study enrolled 99 men and women 60 years of age and older with self-reported arthritis in New York and Florida. Survey participants were asked to respond to questions about comorbid conditions.

Participants also were asked about their weekly levels of physical activity and completed a validated 10-item questionnaire about how they felt about their aging process. Questions on the survey explored both positive aspects (gains) associated with aging, as well as negative aspects (losses), covering topics such as motivation, limitations to daily activities, and a sense of physical energy.

Dr. Lieber and colleagues found that the amount of physical activity people reported was strongly associated with their self-perception of general health, the amount of social support they had, and their feeling that aging was negatively affecting them (P <0.01 for all). However, the strength of the relationship between negative self-perceptions of aging and physical activity was weaker when self-perceptions of general health were taken into consideration.

As a rheumatologist whose patients already may be less likely than others to be getting the recommended amount of physical activity, Dr. Lieber says anything that can encourage exercise is welcome. “Everyone benefits from activity, but people with rheumatic conditions benefit particularly,” she says. “Our findings suggest that interventions to improve physical activity in patients with arthritis may need to target self-perceptions of aging, as well as general health,” Dr. Lieber says. “For example, interventions could help older adults to challenge negative feelings about aging and to develop more positive views of their own aging process. Interventions also could help older adults to identify and address factors that are affecting their general health, such as chronic pain or fatigue.”

Authors: Sarah B. Lieber, MD, MS, Jerad Moxley (Weill Cornell Medicine), Lisa A. Mandl, MD, MPH, M. Carrington Reid (Weill Cornell Medicine), Sara Czaja (Weill Cornell Medicine).