Season 2: Episode 6 - Arthritis Isn’t Just Aging

Andie Cartwright

Welcome to the Better Living Through Data podcast!. Anthony, I want to talk about a dangerous assumption people make about arthritis: that pain is “just a part of aging.” Because more than 58 million U.S. adults live with arthritis, and among adults 75 and older, the prevalence is 53.9%. That is not some little side note of getting older. This is a major issue among the aging population.

Anthony Pero

Right — 53.9% means when you picture a room of adults over 75, more than half that room is dealing with it. And the reason I push on this is that arthritis gets framed as aches and stiffness, when the bigger story is function. More than 25 million adults report arthritis-attributable activity limitation. That phrase sounds clinical, but it means walking, dressing, cooking, getting to the bathroom safely, staying independent.

Andie Cartwright

And “activity limitation” is the part people don’t put on the brochure version of aging, right? They’ll say, “My knees are bad,” but they won’t say, “I stopped going to the store,” or “I don’t take the stairs anymore,” or “I’m exhausted by noon.”

Anthony Pero

Exactly. And the burden is not evenly distributed. It rises with age, yes, but also with income and geography. So when we talk about arthritis, we’re also talking about who has access to support, who can modify a home, who can get to rehab, who has transportation, who has someone checking in. That’s where this becomes a population-health issue, not just a musculoskeletal issue.

Andie Cartwright

That’s the marketing-brain thing I notice too — arthritis has a branding problem. It sounds ordinary. It sounds beige. But the numbers are absolutely not beige. The nation’s leading cause of disability doesn’t get to be filed under “routine.”

Anthony Pero

I’ll add one tension point, though. Some discomfort really is common with aging. We shouldn’t turn every sore joint into a five-alarm event. But — and this is the important “but” — normalizing everything as aging can delay action until function is already slipping. And once somebody’s mobility, endurance, or confidence drops, that decline can compound fast.

Andie Cartwright

That “compound fast” piece matters. Because if you wait until the crisis is obvious, you’ve missed all the quieter signals before it. And that’s where the long-term and post-acute care lens gets really interesting. PointClickCare Life Sciences has electronic health record data on 15 million-plus patients aged 65 and older, averaging 50-plus points per patient per day, spanning over 10 years, with average long-stay length over 800 days. Eight hundred days — that’s not a snapshot, that’s basically a time-lapse film.

Anthony Pero

“Eight hundred days” is the number that sticks for me. That’s over two years of longitudinal visibility. So instead of seeing one rheumatology visit or one bad week, you can watch how function changes over time — walking, eating, frailty indicators, medication changes, even whether respiratory symptoms or fatigue start clustering around the same person.

Andie Cartwright

And from a storytelling perspective, that changes the whole frame. You’re not just asking, “Did this person report pain on Tuesday?” You’re asking, “What was happening 90 days before the pain got worse? What was happening six months after? Did they stop participating in daily activities? Did other conditions pile on?”

Anthony Pero

Yes. And for older adults especially, arthritis almost never travels alone. It intersects with frailty, diabetes, cardiovascular risk, respiratory issues, depression, fall risk — all the things that determine whether someone can live the life they want. Data is what lets us see arthritis in that real-world context instead of in a vacuum.

Andie Cartwright

So let’s make that practical. If we’re talking rheumatoid arthritis and osteoarthritis in older adults, what are the observables you care about before things blow up? Because “joint pain” feels too late in the story.

Anthony Pero

Totally. For me it starts with mobility and energy. Can the person transfer safely? Are they walking less? Is fatigue showing up? Then pain, obviously — but also breathing, because shortness of breath and cough can shape recovery and tolerance. Frailty indicators matter. Medication patterns matter. Comorbidities matter. And then the social layer: isolation, health literacy, payer, even whether someone has the support structure to follow through on care.

Andie Cartwright

Wait — you said breathing. For an arthritis conversation, “shortness of breath” is not what most people would expect.

Anthony Pero

That’s why the dataset is useful. It doesn’t force us into a cartoon version of arthritis. In the RA/OA data collection, categories include clinical and healthcare resource utilization — so hospitalizations, ED visits, number of days between diagnosis and treatment, admission and discharge details, length of stay, medication orders. Then you’ve got lung function measures like peak expiratory flow, FEV1/FVC, bronchodilator response, spirometry test results, shortness of breath, cough, difficulty breathing.

Andie Cartwright

FEV1/FVC in an arthritis dataset — that is exactly the kind of detail that tells you this is about whole-person aging, not just joints. It’s like looking at the entire dashboard instead of one warning light.

Anthony Pero

That’s a good way to put it. And the scale is substantial: over 3 million unique patient records with rheumatoid arthritis and osteoarthritis, and nearly 300,000 active unique RA/OA patient records. When you combine that scale with longitudinal depth, you can start detecting patterns that a clinician, frankly, may feel intuitively but not be able to quantify across populations.

Andie Cartwright

Let me try to play that back. So it’s not just, “Here is a giant pile of records.” It’s segmented into research categories that make the pile usable — clinical utilization, quality of life, smoking status, social drivers of health plus DEI profiles, comorbidities, observations, immunizations. In other words, the record starts to look like an actual person.

Anthony Pero

Almost. The important refinement is that it looks like an actual person over time. Health-related quality of life measures include fatigue, track recovery and deterioration post-infection, pain, frailty indicators, cognitive patterns, and eating — both performance and amount. Observations include respiration, pulse, blood pressure, weight, temperature, oxygen saturation. So if someone’s arthritis seems “stable” on paper, but their weight is changing, their activity is dropping, and they’re becoming more isolated, that is not stable in the lived sense.

Andie Cartwright

“Stable in the lived sense” — that’s good. Because one thing older adults tell us all the time, in all kinds of disease spaces, is that the chart can look better than how the day-to-day feels.

Anthony Pero

Exactly. And smoking status, immunizations, full ICD-10 comorbidity coding — those aren’t throwaway fields. They help researchers and care teams understand risk, resilience, and which interventions might actually fit the person in front of them.

Andie Cartwright

Here’s my pushback, though. Bigger datasets always sound impressive. Two point nine million records, 50-plus points per day, 10 years — great. But if arthritis is still being waved away as “normal aging,” does the data actually change behavior?

Anthony Pero

Not by itself. Data does nothing if it just sits there looking important. What changes behavior is when the data helps answer an earlier question. Who is beginning to withdraw from activity? Who is accumulating fatigue and frailty before a hospitalization? Who might need a different support plan because social isolation, low health literacy, or comorbid burden make standard care unrealistic? That’s where researchers, providers, and health leaders can intervene before the flare-up becomes the headline.

Andie Cartwright

And that feels especially relevant in the middle of May, when arthritis awareness can drift into slogans pretty fast. The useful version of awareness is not “remember arthritis exists.” It’s “stop waiting for visible decline before you take it seriously.”

Anthony Pero

Yes. Because the strategic question isn’t just how to treat pain after it peaks. It’s how to recognize the earlier pattern — mobility changes, fatigue, medication shifts, social risk, worsening function — and personalize support soon enough that an older adult keeps doing the things that make life feel like life.

Andie Cartwright

If better data can help us do that — help somebody keep walking to the mailbox, keep cooking, keep showing up for family, keep a little more independence for a little longer — that’s not a small win. That’s the whole point.

Anthony Pero

And maybe that’s the reframing: arthritis is common, but losing years of fuller living should never feel routine. And on that note, I want to mention to our listeners that if you'd like to learn more about our extensive RA/OA data, and use our newest AI-powered research tool "Study Buddy", check the link in the description for today's episode.

Andie Cartwright

Thanks for joining us today on the Better Living Through Data podcast!

Anthony Pero

Bye everyone! See you next week!