Table 3.
Prospective associations between trauma exposure and incident arthritis over 12 years of follow-up in the Health and Retirement Study (n=2,269)
| Any Arthritis | |||||
|---|---|---|---|---|---|
| Crude | Confounder | Adult Social Factors | Biobehavioral Factors | Depressive Symptoms | |
| Trauma Variables | HR (91%CI) | HR (95%CI) | HR (91%CI) | HR (91%CI) | HR (91%CI) |
| Any Lifetime Trauma | |||||
| No Trauma | Ref | Ref | Ref | Ref | Ref |
| Any Lifetime Trauma | 1.25 (1.07, 1.46) | 1.25 (1.07, 1.47) | 1.25 (1.06, 1.46) | 1.22 (1.04, 1.44) | 1.20 (1.02, 1.42) |
| R2 Nagelkerke | 0.004 | 0.011 | 0.015 | 0.032 | 0.040 |
| Lifecourse Trauma Accumulation | |||||
| Count of Trauma, M (SD) | 1.12 (1.07, 1.19) | 1.13 (1.07, 1.19) | 1.13 (1.07, 1.19) | 1.13 (1.07, 1.19) | 1.11 (1.05, 1.18) |
| R2 Nagelkerke | 0.009 | 0.016 | 0.021 | 0.038 | 0.045 |
| Lifecourse Trauma Profiles a | |||||
| No Trauma | Ref | Ref | Ref | Ref | Ref |
| Childhood Only | 1.41 (1.16, 1.71) | 1.45 (1.19, 1.76) | 1.44 (1.18, 1.75) | 1.41 (1.16, 1.73) | 1.41 (1.15, 1.72) |
| Adult Only | 1.21 (0.97, 1.51) | 1.19 (0.96, 1.48) | 1.20 (0.97, 1.50) | 1.19 (0.95, 1.48) | 1.17 (0.94, 1.46) |
| Both Childhood and Adult | 1.17 (0.88, 1.56) | 1.21 (0.90, 1.61) | 1.19 (0.89, 1.59) | 1.17 (0.87, 1.58) | 1.11 (0.82, 1.49) |
| R2 Nagelkerke | 0.007 | 0.017 | 0.021 | 0.032 | 0.041 |
| Immune-Related Arthritis | |||||
| Crude | Confounder | Adult Social Factors | Biobehavioral Factors | Depressive Symptoms | |
| Trauma Variables | HR (91%CI) | HR (95%CI) | HR (91%CI) | HR (91%CI) | HR (91%CI) |
| Any Lifetime Trauma | |||||
| No Trauma | Ref | Ref | Ref | Ref | Ref |
| Any Lifetime Trauma | 1.00 (0.71, 1.42) | 1.02 (0.72, 1.43) | 1.01 (0.72, 1.43) | 0.95 (0.66. 1.35) | 0.92 (0.65, 1.30) |
| R2 Nagelkerke | 0.000 | 0.017 | 0.019 | 0.026 | 0.032 |
| Lifecourse Trauma Accumulation | |||||
| Count of Trauma, M (SD) | 1.08 (0.95, 1.22) | 1.07 (0.95, 1.21) | 1.07 (0.94, 1.21) | 1.05 (0.92, 1.19) | 1.03 (0.90, 1.17) |
| R2 Nagelkerke | 0.001 | 0.017 | 0.019 | 0.026 | 0.032 |
| Lifecourse Trauma Profiles a | |||||
| No Trauma | Ref | Ref | Ref | Ref | Ref |
| Childhood Only | 1.24 (0.81, 1.90) | 1.29 (0.85, 1.96) | 1.23 (0.81, 1.89) | 1.16 (0.75, 1.80) | 1.16 (0.75, 1.80) |
| Adult Only | 0.71 (0.42, 1.24) | 0.73 (0.42, 1.25) | 0.75 (0.44, 1.30) | 0.71 (0.40, 1.25) | 0.71 (0.41, 1.24) |
| Both Childhood and Adult | 0.61 (0.30, 1.26) | 0.61 (0.30, 1.24) | 0.57 (0.28, 1.18) | 0.54 (0.25, 1.13) | 0.48 (0.23, 1.01) |
| R2 Nagelkerke | 0.004 | 0.026 | 0.031 | 0.035 | 0.042 |
| Osteoarthritis | |||||
| Crude | Confounder | Adult Social Factors | Biobehavioral Factors | Depressive Symptoms | |
| Trauma Variables | HR (91%CI) | HR (95%CI) | HR (91%CI) | HR (91%CI) | HR (91%CI) |
| Any Lifetime Trauma | |||||
| No Trauma | Ref | Ref | Ref | Ref | Ref |
| Any Lifetime Trauma | 1.22 (1.02, 1.48) | 1.23 (1.02, 1.49) | 1.24 (1.03, 1.50) | 1.20 (1.00, 1.45) | 1.18 (0.98, 1.43) |
| R2 Nagelkerke | 0.002 | 0.008 | 0.011 | 0.029 | 0.037 |
| Lifecourse Trauma Accumulation | |||||
| Count of Trauma, M (SD) | 1.13 (1.07, 1.21) | 1.14 (1.07, 1.22) | 1.14 (1.07, 1.22) | 1.14 (1.07, 1.21) | 1.12 (1.05, 1.20) |
| R2 Nagelkerke | 0.007 | 0.013 | 0.016 | 0.035 | 0.041 |
| Lifecourse Trauma Profiles a | |||||
| No Trauma | Ref | Ref | Ref | Ref | Ref |
| Childhood Only | 1.48 (1.18, 1.85) | 1.50 (1.20, 1.87) | 1.51 (1.20, 1.89) | 1.47 (1.17, 1.85) | 1.45 (1.16, 1.83) |
| Adult Only | 1.12 (0.86, 1.46) | 1.13 (0.87, 1.48) | 1.14 (0.87, 1.49) | 1.12 (0.85, 1.46) | 1.10 (0.84, 1.44) |
| Both Childhood and Adult | 1.25 (0.90, 1.74) | 1.30 (0.94, 1.80) | 1.28 (0.93, 1.78) | 1.24 (0.89, 1.72) | 1.17 (0.83, 1.63) |
| R2 Nagelkerke | 0.007 | 0.016 | 0.018 | 0.031 | 0.040 |
n=1,758 due to missing timing of exposures
CI = confidence intervals; PR = prevalence ratio.
Model adjustment: Crude (no covariates), Confounder (age, gender, race, ethnicity), Adult Social Factors (confounders plus educational attainment and marital status), Biobehavioral Factors (confounders, adult social factors, and BMI, alcohol use, smoking, and physical activity), Depressive Symptoms (confounders, adult social factors, biobehavioral factors, and depressive symptoms). Models are adjusted for inverse probability weighting for selection bias. Bolded estimates are significant at p<.05. Immune-related arthritis includes rheumatoid arthritis, gout, and lupus; Osteoarthritis includes osteoarthritis and arthritis due to injury.