Overview of Comorbidity and Arthritis

Older woman getting her hands looked at by a doctor

ADAM GAULT / SPL / Getty Images

The words "comorbidity" and "comorbid condition" are common medical terms. Comorbidity refers to one or more diseases or conditions that occur along with another condition in the same person at the same time.

Conditions considered comorbidities are often long-term or chronic conditions. Other terms that are used interchangeably with comorbidity include coexisting conditions, co-occurring conditions, multimorbidity, or multiple chronic conditions (although important distinctions differentiate these terms).

Comorbidity and Arthritis

Using rheumatoid arthritis as an example, there are comorbidities associated with the disease which are nonarticular manifestations. These are conditions that affect body parts other than joints. These tend to occur with a higher frequency than would be expected in the normal population.

These include conditions such as subcutaneous rheumatoid nodules, vasculitis, neuritis, Sjogren's syndrome, and Felty's syndrome. Although these conditions are not found in all people with rheumatoid arthritis, when present, they may influence treatment.

Comorbid conditions can also include diseases and conditions other than rheumatic conditions. It can refer to arthritis together with diabetes, heart disease, or cancer as well. Comorbidities may lead to the development of anxiety and depression as people face multiple treatments and growing costs associated with it.

Comorbidity Statistics

Nearly half of adults in the United States with arthritis also have at least one other chronic condition. While heart disease is the most common, diabetes, obesity, high cholesterol, and chronic respiratory conditions are high on the list as well.

The Centers for Disease Control reveal that in the United States:

  • 49 percent of adults with heart disease also had arthritis.
  • 47 percent of adults with diabetes also had arthritis.
  • 31 percent of adults who are obese have arthritis.

Why Is Comorbidity Common With Arthritis?

There is no concrete answer regarding why it is common for people with arthritis to have comorbidities. Speculation has pointed to non-modifiable risk factors as well as modifiable risk factors that are associated with arthritis and comorbidities. In other words, they have things in common.

Age is an example of a non-modifiable risk factor that would be common with most comorbidities. Obesity and smoking are examples of shared modifiable risk factors. The CDC has emphasized the importance of remaining physically active to help arthritis as well as the comorbidity.

Despite the emphasis on remaining active:

  • 1 in 5 people is physically inactive with heart disease or diabetes alone.
  • 1 in 3 people is physically inactive with either heart disease or diabetes and arthritis comorbidity.

Arthritis clearly adds to the burden of managing these other conditions.

General Consequences of Comorbidity

Generally, comorbidity is tied to worsening health outcomes, the need for more complex treatment and disease management, and higher health care costs.

It's not unusual to be faced with managing multiple chronic conditions. In 2017, nearly 67 percent of Medicare fee for service spending went to people with two or more chronic conditions. Medicare beneficiaries with six or more conditions make up only 17% percent, but the cost is nearly 53% percent of total expenditures.

Another point that researchers have considered, with regard to comorbidity, is the chronology of the conditions. It may be significant which disease occurred first. For example, knowing whether arthritis or depression developed first may have implications regarding disease onset, prognosis, and treatment.

When selecting from treatment options for comorbidities, it is also important to recognize and steer clear of treatments that are antagonistic. Using a particular treatment for one condition may further complicate the other.

What You Can Do

Researchers are increasingly concerned about the rise in comorbidity among people with arthritis. As the U.S. population ages, they are looking at ways to mitigate the effects of treating multiple chronic conditions.

Treatments for multiple conditions can include conflicting medical advice, increased cost, and duplicative tests or adverse medication effects. The medical community is recognizing this and many doctors are working on a more patient-centered approach.

If you have other conditions along with arthritis, speak to your doctor and healthcare team about ways to address the problems you face. Increasing physical activity, coordinating doctor appointments and tests, and properly managing medications are just a few of the suggestions.

Every case is different and although some people prioritize their various health conditions, this is not the best idea. It's recommended that you work with your doctors to devise a healthcare plan that addresses your entire health. This can lead to a higher quality of life.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Meghani SH, Buck HG, Dickson VV, et al. The conceptualization and measurement of comorbidity: a review of the interprofessional discourse. Nurs Res Pract. 2013;2013:192782. doi:10.1155/2013/192782

  2. Turesson C. Comorbidity in rheumatoid arthritis. Swiss Med Wkly. 2016;146:w14290. doi:10.4414/smw.2016.14290

  3. National Rheumatoid Arthritis Society (UK). The impact of rheumatoid arthritis co-morbidities. December 2012

  4. Theis KA, Brady TJ, Helmick CG. No one dies of old age anymore: a coordinated approach to comorbidities and the rheumatic diseases. Arthritis Care Res (Hoboken). 2017;69(1):1-4. doi:10.1002/acr.23114

  5. Centers for Disease Control and Prevention. Arthritis, data and statistics: comorbidities. Updated May 16, 2016.

  6. Kłodziński Ł, Wisłowska M. Comorbidities in rheumatic arthritis. Reumatologia. 2018;56(4):228-233. doi:10.5114/reum.2018.77974

  7. Lahiri M, Morgan C, Symmons DP, Bruce IN. Modifiable risk factors for RA: prevention, better than cure? Rheumatology (Oxford). 2012;51(3):499-512. doi:10.1093/rheumatology/ker299

  8. Mcphail SM. Multimorbidity in chronic disease: impact on health care resources and costs. Risk Manag Healthc Policy. 2016;9:143-56. doi:10.2147/RMHP.S97248

  9. U.S. Centers for Medicare & Medicaid Services. Chronic conditions charts: 2017.

  10. Tegethoff M, Stalujanis E, Belardi A, Meinlschmidt G. Chronology of onset of mental disorders and physical diseases in mental-physical comorbidity - a National Representative Survey of Adolescents. PLoS ONE. 2016;11(10):e0165196. doi:10.1371/journal.pone.0165196

  11. Zulman DM, Asch SM, Martins SB, Kerr EA, Hoffman BB, Goldstein MK. Quality of care for patients with multiple chronic conditions: the role of comorbidity interrelatedness. J Gen Intern Med. 2014;29(3):529-537. doi:10.1007/s11606-013-2616-9

  12. Sinaiko AD, Szumigalski K, Eastman D, Chien AT. Delivery of patient centered care in the U.S. health care system: what is standing in its way? AcademyHealth. August 2019.

Additional Reading