Musculoskeletal disability among elderly people in the community

Abstract

ObjectivesTo determine the prevalence and determinants of disability among elderly people living in the community. DesignA cross‐sectional postal questionnaire survey. SettingNorthern Sydney Area Health Service. Participants1527 residents (622 men and 905 women) aged 65 years and over. Main outcome measuresSelf‐reported chronic illnesses, injuries or conditions; difficulties with activities of daily living assessed by the Health Assessment Questionnaire (HAQ); and home modification and use of functional aids. Results“Arthritis or rheumatism” was the leading long term condition, reported by 59.5%, 55.8% and 59.7% of women and 40.5%, 47.0% and 43.6% of men in the three age groups (65‐74, 75‐84 and 85 years and over), respectively. The back, neck and knees were the most common sites of pain and stiffness. Of the respondents, 23.4% of women and 24.3% of men reported regularly taking non­ steroidal anti‐inflammatory drugs. Impaired performance of activities of daily living increased with age, with 53.9%, 70.7% and 89.6% of women and 37.6%, 63.6% and 73.2% of men in the respective age groups reporting at least some difficulty (HAQ score> 0). Multivariate analysis found self‐reported poor general health, loss of a limb, arthritis or rheumatism, other long term conditions restricting physical activity, impaired vision, female sex, and age to be significant predictors of disability as measured by HAQ scores. Only 13.9% of women and 9.4% of men had made changes to their home. Functional aids were used by 27.7%, 37.3% and 65.9% of women and 15.6%, 33.4% and 59.1% of men in the respective age groups. ConclusionArthritis and rheumatism were the most prevalent chronic conditions among elderly people in the community, and were significantly associated with difficulty with performing activities of daily living, after controlling for effects of age, sex and other chronic conditions.

The global burden of neck pain: estimates from the Global Burden of Disease 2010 study

“…One of these was the World Mental Health Survey estimate from Ukraine as its reported 1 year prevalence of chronic back or neck pain of 42.2% was three SDs higher than the mean of 18 World Mental Health Survey estimates while the next highest estimate was 1.2 SD units above the mean 23. The other study removed was an Australian study which was a postal survey with low response rate, and had an undue upward effect on the region's estimates 24. This left a total of 218 estimates from 56 studies.…”

Acompanhamento da capacidade funcional de pacientes com artrite reumatoide por três anos

“…19 Em nossa amostra de pacientes com AR e idade média de 58 anos, a pontuação no HAQ de 1,1 é equivalente a de idosos de 85 anos. 18 20 Embora a literatura preconize uma alteração de 0,24 na pontuação do HAQ como clinicamente relevante, 21 reduç ões de 0,19; já podem ser referidas como uma melhora mínima na função. 20 A capacidade funcional medida pelo HAQ é influenciada não apenas pela idade ou pelo tempo de doença, mas também pelos níveis de dor e pelas medicaç ões em uso.…”

Monitoring the functional capacity of patients with rheumatoid arthritis for three years

“…In fact, the EPM-ROM score is sensitive to the modification of functional status, translating the goniometry required to perform the basic activities of life. 17 Even in healthy individuals, there is loss of functional capacity throughout life; 18 and in RA patients, such a loss is more significant. 19 In our sample of RA patients with a mean age of 58 years, an HAQ score of 1.1 is equivalent to the score for people aged 85 years.…”

“…19 In our sample of RA patients with a mean age of 58 years, an HAQ score of 1.1 is equivalent to the score for people aged 85 years. 18 Sokka et al, assessing functional capacity in RA patients, established that HAQ values smaller than 1 would mean a milder disease, while values above 2 would suggest a severe illness. 12 The annual increase in HAQ score found by these authors was confirmed by Scott et al These authors found an annual increase of 1% in HAQ score.…”