The spectrum of anguish from osteoarthritis sparks physiological or psychological needs in the young–old and the old–old determined by gender

Knee osteoarthritis (KOA) inducing physiological pain and psychological health which is a public health issue in the older adults. However, research about the gender-specific effects on young-old and old-old is still scarce. The aim was to explore the vulnerability of physiology and psychology to KOA among the young-old and the old-old by gender. This case-control study recruited participants from health examinations at the Tri-Service General Hospital between March 2015 and October 2019. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the 12-item short-form survey (SF-12) were used to evaluate the health status and quality of life (QoL) of subjects. Kellgren-Lawrence grading system (KL) was adopted to assess knee radiographs of subjects, KL grade ≥ 2 as KOA patients (KL grade ≥ 3 as severe KOA patients) and KL grade < 2 as controls. Student t-test and χ2 test were used to compare the distribution differences between KOA patients and controls, including demographic data, health statuses and QoL. The association of KOA and QoL was determined using multiple regression analysis. There were 772 subjects (young-old, n = 543; old-old, n = 229) in this study, 406 KOA patients (including 85 severe KOA patients) and 366 healthy individuals. In the young-old, KOA may play a least role in health status and QoL. However, in the old-old, males with severe KOA would cause a decrease in SF-12 mental component summary score (MCS) (β= -13.75, 95% CI: -23.90 to -3.61); however, females with severe KOA would cause a decrease in SF-12 physical functioning domain (β = -19.44; 95% CI: -35.32 to -3.56). The spectrum of anguish from KOA leads to differential reduction of QoL determined by age and gender. This study provides a glimpse on physiological and psychological need among the young-old and the old-old with KOA by gender.