Determinants of generalized fatigue in individuals with symptomatic knee osteoarthritis: the MOST Study

Henrietta O. Fawole*, Jody L. Riskowski, Andrea Dell'Isola, Martijn P. Steultjens, Michael C. Nevitt, James C. Torner, Cora E. Lewis, David T. Felson, Sebastien F.M. Chastin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


AIM: The aim of the study was to identify sociodemographic, disease-related, physical and mental health-related determinants of fatigue at 2-year follow-up in individuals with symptomatic knee osteoarthritis (OA).

METHODS: A longitudinal analysis of participants with symptomatic knee OA from the Multicenter Osteoarthritis Study (MOST) was conducted to identify predictors of fatigue at 2-year follow-up. Participants self-reported fatigue at baseline for the first time in the MOST cohort and at follow-up using a 0-10 visual analog scale. At baseline, questionnaires on sociodemographics, disease-related symptoms, physical and mental health factors were completed. Data were analyzed using linear regressions with a backwards elimination approach.

RESULTS: Of the 2330 individuals in the MOST cohort at baseline, 576 had symptomatic knee OA and of these, 449 with complete fatigue values at baseline and follow-up were included in this analysis. Minimally important fatigue change (ie, worsening [≥1.13], no change [<0.82 or <1.13] and improvement [≥-0.82]) from baseline to follow-up were unequal within the population (34.5%, 26.9%, 38.5%; χ2 [2, N = 449] = 9.32, P = .009). The multiple linear regression showed that baseline fatigue (unstandardized coefficient [Β] = 0.435; 95% confidence interval [CI] 0.348-0.523, P < .001), slow gait speed (Β = -1.124; 95% CI -1.962 to -0.285, P = .009), depressive symptoms (Β = 0.049; 95% CI 0.024-0.075, P < .001) and higher numbers of comorbidities (Β = 0.242; 95% CI 0.045-0.439, P = .016) were significant predictors of greater fatigue at follow-up.

CONCLUSION: Fatigue is strongly associated with physical- and mental-related health factors. Individualized treatments that include combined psychological and physical function rehabilitation might be modalities for fatigue management.

Original languageEnglish
Pages (from-to)559-568
Number of pages10
JournalInternational journal of rheumatic diseases
Issue number4
Early online date28 Jan 2020
Publication statusPublished - Apr 2020


  • fatigue
  • knee osteoarthritis
  • longitudinal
  • risk factors

ASJC Scopus subject areas

  • Rheumatology


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