Prevalence and correlates of the use of complementary and alternative medicines among older adults with joint pain.

BACKGROUND: There is increasing use of complementary and alternative medicines (CAMs) alone or as an adjuvant therapy to conventional medicines in osteoarthritis (OA) patients. OBJECTIVES: This study aimed to describe the prevalence and correlates of the use of CAMs among community-dwelling older adults. METHODS: Data from the Tasmania Older Adult Cohort Study (TASOAC, n = 1099) were used to describe the prevalence of CAM use. Correlates of CAM use were assessed by comparing CAM users and non-users. To further assess correlates of CAM use, participants with at least one joint with pain were classified into four categories: CAM-only, analgesics-only, co-therapy, and "neither CAMs nor analgesics" (NCNA). RESULTS: In all, 385 (35.0%) of our participants reported use of CAMs, among which vitamins/minerals were used most (22.6%, n = 232). Compared with CAM non-users, CAM users were more likely to be female, were less likely to be overweight, were better educated, had more joints with OA, had fewer WOMAC scores, and did more steps per day. Among participants with any joint pain, the CAM-only group were less likely to be overweight, consumed more alcohol, had higher quality of life, had more steps per day, and had fewer pain-related symptoms compared with the analgesic-only group. CONCLUSION: Complementary and alternative medicines were commonly used among Tasmanian older adults, with 35% of the population using CAMs either alone or in combination with conventional analgesics. CAM users were more likely to be female, be better educated, have more joints with OA, and had healthier lifestyles, including lower body mass index and higher number of steps per day.

Population Vitamin D Stores Are Increasing in Tasmania, and This Is Associated With Less BMD Loss Over 10 Years.

CONTEXT: Vitamin D deficiency is a common, modifiable determinant of musculoskeletal health. OBJECTIVE: There are limited data that examine the longitudinal change in population 25-hydroxyvitamin D (25[OH]D) and none that evaluate the long-term skeletal outcomes of longitudinal vitamin D status. METHODS: A prospective cohort analysis was conducted of community-dwelling adults aged 50 to 80 years who had 25(OH)D assessed by radioimmunoassay and bone mineral density (BMD) by dual-energy x-ray absorptiometry at baseline (n = 1096), 2.5 (n = 870), and 10 (n = 565) years. Sun exposure was quantified by questionnaire and supplement use at clinic review. 25(OH)D less than 50 nmol/L was considered deficient. Participants were provided with their 25(OH)D results. RESULTS: Over 10 years 25(OH)D increased (52.2 ±â€…17.0 to 63.5 ±â€…23.6 nmol/L, P < .001). Participants with baseline deficiency had larger 25(OH)D increases than baseline sufficient participants (19.2 ±â€…25.3 vs 1.6 ±â€…23.3 nmol/L, P < .001). Longitudinal change in 25(OH)D was associated with baseline summer (ß = 1.46, P < .001) and winter (ß = 1.29, P = .003) sun exposure, change in summer (ß = 1.27, P = .002) and winter (ß = 1.47, P < .001) sun exposure, and vitamin D supplement use (ß = 25.0-33.0, P < .001). Persistent vitamin D sufficiency was associated with less BMD loss at the femoral neck (ß = 0.020, P = .027), lumbar spine (ß = 0.033, P = .003), and total hip (ß = 0.023, P = .021) compared to persistent vitamin D deficiency. Achieving vitamin D sufficiency was associated with less BMD loss at the lumbar spine (ß = 0.045, P < .001) compared to persistent vitamin D deficiency. CONCLUSIONS: Population 25(OH)D concentration increased because of a combination of increased sun exposure and supplement use. Maintaining or achieving vitamin D sufficiency was associated with less BMD loss over 10 years.