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More than 20% of the American adult population had some form of arthritis during 2019-2021, according to CDC researchers, with the prevalence reaching nearly 50% for those age 65 and older.

Rates were even higher for people with other conditions such as dementia, stroke history, and chronic obstructive pulmonary disease (COPD), Elizabeth A. Fallon, PhD, of the CDC's National Center for Chronic Disease Prevention and Health Promotion in Atlanta, and colleagues .

With some 53 million people affected, the public health implications are correspondingly massive, the researchers suggested. Because physical activity is well recognized as both preventing arthritis and reducing its impacts when it does occur, clinicians and communities should do more to encourage everyone to exercise.

"A recommendation from a health care provider can increase the likelihood that adults with arthritis attend education programs and engage in physical activity," Fallon and colleagues pointed out. As well, they added, "[i]ncreasing equitable access to physical activity opportunities within the built environment and across settings (e.g., worksites, community organizations, and home)" should be a priority as well.

Of course, individuals can take responsibility for their own health. "Maintaining a healthy weight, engaging in sufficient physical activity, and avoiding joint injury are important for prevention," the researchers wrote.

Data from the for 2019-2021 powered the analysis. Roughly 30,000 people participated each year during this period. Among the questions were, "Have you ever been told by a doctor or other health care professional that you have arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?" (Similar questions addressed numerous other health conditions.) Responses were weighted to more closely represent the overall U.S. population in terms of age, sex, race/ethnicity, and other factors.

Many of the factors that were associated with arthritis risk come with age and help explain why arthritis prevalence was especially large. Nevertheless, even after adjustment for respondents' age, markedly more people with dementia, diabetes, previous stroke, and COPD reported arthritis diagnoses than those without these conditions:

• Dementia: 47.8% prevalence vs 18.6%
• COPD: 43.5% vs 17.6%
• Stroke: 39.0% vs 18.3%
• Diabetes: 28.8% vs 17.8%

Unadjusted data showed arthritis prevalences well above 50% for several of these comorbidities.

Social determinants also made an appearance in the report. People who didn't finish high school and those with low incomes were also more likely to report an arthritis diagnosis. In the case of educational attainment, the trend weakened after age adjustment, but it was still very evident with regard to income. People with "high" incomes (more than 400% of the federal poverty level) had an age-adjusted arthritis prevalence of 15.7%, compared with 25.1% among participants making less than 125% of poverty level.

Military veterans also had higher rates than non-vets, at 24.2% versus 18.5% after age adjustment. The gap was much wider before age was taken into account. That was to be expected insofar as veterans were more likely to suffer injuries that predispose to arthritis.

As well, women were more likely than men to have arthritis, even after adjusting for age (20.9% vs 16.3%).

Fallon and colleagues cautioned that their prevalence figures should not be compared to those from earlier NHIS-based reports. A survey redesign in 2019 resulted in "reordering and eliminating some arthritis-relevant questions, which might have led to differences in respondents' ability to recall an arthritis diagnosis," the team explained. In the earlier data, the overall arthritis prevalence in adults was put at 23.7%, as opposed to 21.2% unadjusted in the current report, and 18.7% with age-adjustment.

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