The association between the residential environment and arthritis among the elderly in China: evidence from cohort and cross-sectional studies

Background: Arthritis, characterised by inflammation, pain, and joint stiffness, is emerging as a significant health concern in ageing populations worldwide. While many studies have examined the effects of outdoor environmental risk factors on arthritis, fewer have investigated the effects of residential ecological factors. Methods: We included 2,511 participants in the cohort study and 13,886 participants in the cross-sectional study from the Chinese Longitudinal Healthy Longevity Survey. We employed multivariate Cox proportional hazards and logistic regression to analyse the cohort and cross-sectional data. For each residential environment factor, we developed three models, with model three adjusted for all potential confounders collected in our study, which we considered our primary model. Results: We identified a significant association between the use of non-clean fuel and a higher risk of arthritis (hazard ratio (HR) = 1.42; 95% confidence interval (CI) = 1.05-1.93) through cohort analysis. Conversely, residing in high-rise buildings with elevators was associated with a reduced risk of arthritis (HR = 0.12; 95% CI = 0.02-0.86). Our cross-sectional study reflects a reduced risk of arthritis associated with summer window ventilation for one to five times/week (odds ratio (OR) = 0.70; 95% CI = 0.50-0.97) and more than five times/week (OR = 0.66; 95% CI = 0.48-0.90). Additionally, distance of >300 m was also associated with a lower risk of arthritis (OR = 0.79; 95% CI = 0.69-0.89). Conclusion: These findings underscore the crucial role of residential environmental factors in the risk of arthritis development. These results have important implications for public health policies aimed at reducing the prevalence of arthritis.