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

短距离行走或基本日常生活活动（ADL）等基本任务的困难增加 随着年龄的增长而迅速，并在老年时变得普遍。这些残疾对教育质量有不利影响。 生活在老年人，是其他不良后果的危险因素，包括死亡和疗养院的使用。 大多数老年人的残疾是由许多危险因素的长期相互作用不知不觉地发展而来的。 肌肉骨骼疾病，如关节炎和背痛是残疾的重要介质。然而，在这方面， 很少有研究使用长期随访来检查中年肌肉骨骼疾病的影响 关于晚年残疾这样做很重要，因为这些条件对残疾的影响可能是缓慢的 和进步。因此，这些条件对老年人残疾的全面影响可能是 除非观察在老年开始之前就开始，并持续很长一段时间，否则会被低估。 我们建议创新地利用以人口为基础的健康与退休研究， 检查自我报告的中年肌肉骨骼疾病（关节炎和背痛）对晚年生活的影响 残疾（行走困难和ADL困难）。我们将随访9759名年龄在51-61岁之间的受试者， 1992年入学，到2008年，年龄在67-77岁之间。在基线时，受试者报告存在 关节炎和背痛的症状。在每2年的随访中，受试者报告他们是否有困难 有基本的日常生活活动（洗澡、穿衣、转移、排便和进食）和活动能力 （步行不同距离和楼梯）。我们计划了一系列全面的目标， 中年肌肉骨骼状况对晚年残疾的影响，其他人口统计学因素的影响， 特征和共病条件对这些关系的影响，以及关节炎和背痛对 与残疾密切相关的其他结局，包括死亡、疗养院使用、照顾者负担，以及 退休我们的目的是：（1）检查中年自我报告的有症状的关节炎对以后的影响。 生活残疾，包括难以进行基本的日常生活活动和行动困难;（2）检查 中年背痛对晚年残疾的影响;（3）检查关节炎和背部是否有影响 残疾疼痛在由种族、性别和社会经济地位定义的人口统计学群体中存在差异;（4） 检查关节炎和背痛对残疾的影响是否因存在以下情况而不同： 其他共病的医疗条件，肥胖，抑郁症;（5）检查关节炎和背痛是否是 与残疾的常见后果（如照顾者负担、护理 家庭安置和死亡;（6）确定关节炎和背痛是否与早期 退休以及提前退休是否确定了关节炎和背痛的受试者子集， 尤其是后续残疾的风险更高。

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.