Do Mid-Life Musculoskeletal Conditions Lead to Disability in the Elderly?

中年肌肉骨骼疾病会导致老年人残疾吗？

• 批准号: 7106272
• 负责人: KENNETH E. COVINSKY
• 金额: $ 7.21万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-01-01 至 2010-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7106272
• 关键词: aging; arthritis; backache; conditioning; death; functional ability; gait; lead; retirement

Difficulty with basic tasks such as walking a short distance or basic activities of daily living (ADL) rises rapidly with age and becomes common in old age. These disabilities have detrimental effects on quality of life in older people, and are risk factors for other adverse outcomes including death and nursing home use. Most disability in the elderly develops insidiously from the long term interaction of many risk factors. Musculoskeletal conditions such as arthritis and back pain are important mediators of disability. However, few studies have used long periods of follow-up to examine the impact of mid-life musculoskeletal conditions on later life disability. Doing so is important because the impact of these conditions on disabilty is likely slow and progressive. As a result, the full impact of these conditions on disability in the elderly is likely to be underestimated unless observation begins before the onset of old age, and continues for long time periods. We propose to make innovative use of the population-based Health and Retirement Study (HRS) to examine the impact of self-reported mid-life musculoskeletal conditions (arthritis and back pain) on later life disability (walking difficulty and difficulty with ADL). We will follow 9759 subjects who were age 51-61 when enrolled in 1992 and will range in age from 67-77 by 2008. At baseline, subjects reported the presence of symptomatic arthritis and back pain. At each 2-year follow-up subjects report whether they have difficulty with basic activities of daily living (bathing, dressing, transferring, toileting, and eating) and with mobility (walking various distances and up stairs). We plan a comprehensive series of aims that will determine the impact of mid-life musculoskeletal conditions on later life disability, the impact of other demographic characteristics and comorbid conditions on these relationships, and the impact of arthritis and back pain on other outcomes closely related to disabilty including death, nursing home use, caregiver burden, and retirement. Our aims are to: (1)examine the impact of self-reported symptomatic arthritis in mid-life on later life disability, including difficulty performing basic activities of daily living and mobility difficulties; (2)examine the impact of back pain in mid-life on later life disability; (3)examine whether the impact of arthritis and back pain on disability differs in demographic groups defined by race, gender, and socio-economic status; (4) examine whether the impact of arthritis and back pain on disability differs depending on the presence of other comorbid medical conditions, obesity, and depression; (5)examine whether arthritis and back pain are associated with outcomes that are common consequences of disability such as caregiver burden, nursing home placement, and death; (6)determine whether arthritis and back pain are associated with early retirement and whether early retirement identifies a subset of subjects with arthritis and back pain at particularly high risk for subsequent disability.

短距离步行或日常生活基本活动(ADL)等基本任务的困难增加 随着年龄的增长迅速增加，并在老年时变得普遍。这些残疾对生活质量有不利影响 老年人的生活，是其他不良后果的危险因素，包括死亡和使用养老院。 大多数老年人的残疾是在许多危险因素的长期相互作用中潜移默化地发展起来的。 肌肉骨骼疾病，如关节炎和背部疼痛，是残疾的重要媒介。然而， 很少有研究使用长时间的随访来检查中年肌肉骨骼状况的影响。 关于晚年的残疾。这样做很重要，因为这些情况对残疾的影响可能是缓慢的。 而且是进步的。因此，这些情况对老年人残疾的全面影响可能是 被低估，除非观察在老年到来之前开始，并持续很长一段时间。 我们建议创新地利用以人口为基础的健康和退休研究(HRS)来 检查自我报告的中年肌肉骨骼状况(关节炎和背痛)对晚年生活的影响 残疾(行走困难和日常生活活动能力障碍)。我们将跟踪调查9759名年龄在51-61岁之间的受试者 1992年入学，到2008年将从67岁到77岁不等。在基线时，受试者报告存在 有症状的关节炎和背部疼痛。在每两年的随访中，受试者报告他们是否有困难 具有基本的日常生活活动(洗澡、穿衣、转移、如厕和吃饭)和活动能力 (走不同的距离和上楼)。我们计划一系列全面的目标，以确定 中年肌肉骨骼状况对晚年残疾的影响，其他人口统计学的影响 这些关系的特征和并存情况，以及关节炎和背痛对 其他与残疾密切相关的结果，包括死亡、养老院的使用、照顾者的负担以及 退休了。我们的目标是：(1)检查中年自我报告的症状性关节炎对晚年的影响 生活残疾，包括日常生活基本活动能力障碍和行动不便；(2)检查 中年背部疼痛对晚年残疾的影响；(3)检查关节炎和背部是否有影响 残疾的痛苦在由种族、性别和社会经济地位定义的人口群体中有所不同；(4) 检查关节炎和背部疼痛对残疾的影响是否取决于是否存在 其他疾病，肥胖和抑郁；(5)检查关节炎和背部疼痛是否 与残疾的常见后果相关，如照顾者负担、护理 家庭安置和死亡；(6)确定关节炎和背部疼痛是否与早期 退休以及提前退休是否确定了患有关节炎和背痛的受试者的子集 特别是后续残疾的风险很高。