Vigorous physical activity shows the most consistent association with quality of life compared with smoking and body mass in adults with osteoarthritis and hip and/or knee pain: A longitudinal cohort study

Musculoskelet Sci Pract. 2026 Mar 27;83:103551. doi: 10.1016/j.msksp.2026.103551. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the longitudinal association between quality of life and lifestyle factors in middle-aged and older adults with osteoarthritis and hip and/or knee pain.

METHODS: We conducted a longitudinal cohort study using data from waves 5 to 9 of the Survey of Health, Aging, and Retirement in Europe (SHARE). Participants aged 50 years or older who reported osteoarthritis and hip and/or knee pain were included. Quality of life was assessed using the CASP-12 scale. Time-varying lifestyle exposures included vigorous physical activity (PA), BMI category, and smoking. Linear mixed-effects models with random intercepts for participants were used, controlling for age, sex, country, education level, number of chronic diseases, and time-varying living arrangements.

RESULTS: We included 4955 participants (70.8% women) from 15 countries, with a mean age of 69.6 (SD: 10.1) years. Vigorous PA was significantly associated with a higher quality of life. Compared to those who hardly ever engaged in vigorous PA, participants who reported doing so 1-3 times a month (β = 2.357, 95%CI: 1.451-3.262), once per week (β = 2.287, 95%CI: 1.517-3.057) or more than once per week (β = 2.462, 95%CI: 1.832-3.092) had significantly higher CASP-12 scores. Current smoking status and underweight were also associated with lower quality of life, while no significant differences were found in overweight or obese categories.

CONCLUSION: Vigorous PA showed the largest and most consistent association with quality of life over time among the lifestyle factors examined. These findings support the clinical relevance of lifestyle assessment and counseling, highlighting PA as a key target for healthy aging.

PMID:41916187 | DOI:10.1016/j.msksp.2026.103551