State Key Laboratory of Complex Severe and Rare Diseases, Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Beijing Key Laboratory for Genetic Research of Skeletal Deformity, Beijing, China.
Orthop Surg. 2024 Dec;16(12):3129-3140. doi: 10.1111/os.14263. Epub 2024 Nov 4.
OBJECTIVES: Understanding the patterns and implications of coexisting musculoskeletal conditions is crucial for developing effective management strategies and improving care for older adults. This study aimed to examine the associations between musculoskeletal multimorbidity burden and trajectory and holistic well-being among middle-aged and older adults. METHODS: This prospective study employed data from nine consecutive waves of the English Longitudinal Study of Aging (ELSA), spanning 2002-2018. We used latent class trajectory models (LCTM) to identify groups based on changes in musculoskeletal multimorbidity status. Subsequently, we employed linear mixed models to investigate the associations between musculoskeletal disease burden, trajectory groups, and seven dimensions of holistic well-being: Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), depression, memory, loneliness, social interactions, and life satisfaction. RESULTS: In total, 5272 participants (mean age: 71.9 years; SD: 8.9) were included in the final analysis. Four distinct trajectories were identified: a low-burden group (48.37%), an emerging group (14.76%), a moderate-burden group (26.00%), and a persistent burden group (10.87%). After adjustment, the findings demonstrate that the musculoskeletal disorder burden significantly impacts ADLs, depression, memory, social interactions, and life satisfaction in middle-aged and older adults, with minor effects on IADLs and loneliness. Moreover, with the escalation of the burden, its impact significantly intensifies (p for trend is < 0.001). Compared with the low-burden group, participants in both the moderate and persistent burden groups exhibited significantly lower capabilities in ADLs, poorer memory, increased social interactions, and lower life satisfaction. The emerging group displayed a similar trend, though without statistically significant results. CONCLUSIONS: Our study suggests that the extent and persistence of musculoskeletal disease burden can significantly affect holistic well-being among middle-aged and older individuals.
目的：了解肌肉骨骼共存疾病的模式和影响对于制定有效的管理策略和改善老年人的护理至关重要。本研究旨在探讨中老年人肌肉骨骼多病共存负担和轨迹与整体健康之间的关联。
方法：本前瞻性研究使用了 2002-2018 年连续九波英国老龄化纵向研究（ELSA）的数据。我们使用潜在类别轨迹模型（LCTM）根据肌肉骨骼多病共存状态的变化来识别组。随后，我们使用线性混合模型来研究肌肉骨骼疾病负担、轨迹组与整体健康的七个维度（日常生活活动（ADL）、工具性日常生活活动（IADL）、抑郁、记忆、孤独、社交互动和生活满意度）之间的关联。
结果：共有 5272 名参与者（平均年龄：71.9 岁；标准差：8.9）纳入最终分析。确定了四个不同的轨迹：低负担组（48.37%）、新兴组（14.76%）、中负担组（26.00%）和持续负担组（10.87%）。调整后，结果表明，肌肉骨骼疾病负担对中老年人的 ADL、抑郁、记忆、社交互动和生活满意度有显著影响，对 IADL 和孤独的影响较小。此外，随着负担的加重，其影响显著加剧（趋势检验的 p 值<0.001）。与低负担组相比，中负担和持续负担组的参与者在 ADL 方面的能力明显较低，记忆力较差，社交互动增加，生活满意度降低。新兴组也呈现出类似的趋势，但没有统计学意义。
结论：本研究表明，肌肉骨骼疾病负担的程度和持续性会显著影响中老年人的整体健康。
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