Nguyen Andrew, Lee Philip, Rodriguez Edward K, Chahal Karen, Freedman Benjamin R, Nazarian Ara
Harvard Medical School, Boston, MA, USA; Musculoskeletal Translational Innovation Initiative, Carl J Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.
John A Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
Lancet Healthy Longev. 2025 May;6(5):100707. doi: 10.1016/j.lanhl.2025.100707. Epub 2025 May 14.
The prevalence of musculoskeletal diseases such as osteoarthritis, osteoporosis, sarcopenia, and rheumatoid arthritis is rising sharply with global ageing, increasing disability rates among older adults (aged ≥60 years), diminishing quality of life, and burdening health-care systems. Current musculoskeletal care for older adults faces multiple limitations, including comorbidities, frailty, and fragmented care. High osteoarthritis prevalence in individuals older than 55 years, the mounting economic burden of osteoporotic fractures, the growing concern of muscle mass decline, and insufficient guideline implementation collectively underscore these challenges. In the USA, musculoskeletal diseases affect over 121 million people and account for the highest rate of disability among all disease groups, underscoring the need for targeted strategies. Although promising solutions encompassing advanced pharmacological therapies, regenerative medicine, and digital health technologies (including artificial intelligence) are available, they remain underutilised in existing care models. This Personal View discusses the need for personalised, multidisciplinary approaches to address these issues, advocating for collaboration among the orthopaedic, geriatric, and health-care sectors in the USA. We propose that prevention of musculoskeletal diseases is key to its effective management in ageing populations, alongside a holistic, scalable approach that integrates diagnostics, therapy, and telemedicine. Early intervention, interdisciplinary collaboration, and personalised care are essential to improving patient outcomes and addressing the growing musculoskeletal disease burden in the USA.
随着全球老龄化,骨关节炎、骨质疏松症、肌肉减少症和类风湿性关节炎等肌肉骨骼疾病的患病率急剧上升,导致老年人(年龄≥60岁)的残疾率增加、生活质量下降,并给医疗保健系统带来负担。目前针对老年人的肌肉骨骼护理面临多种限制,包括合并症、身体虚弱和护理碎片化。55岁以上人群骨关节炎患病率高、骨质疏松性骨折的经济负担不断增加、对肌肉量下降的日益关注以及指南实施不足,共同凸显了这些挑战。在美国,肌肉骨骼疾病影响着超过1.21亿人,在所有疾病组中残疾率最高,这凸显了制定针对性策略的必要性。尽管有包括先进药物疗法、再生医学和数字健康技术(包括人工智能)在内的有前景的解决方案,但它们在现有护理模式中的利用率仍然很低。这篇个人观点文章讨论了采用个性化、多学科方法来解决这些问题的必要性,倡导美国骨科、老年医学和医疗保健部门之间的合作。我们认为,预防肌肉骨骼疾病是在老龄化人群中有效管理该疾病的关键,同时还需要一种整合诊断、治疗和远程医疗的全面、可扩展的方法。早期干预、跨学科合作和个性化护理对于改善患者预后以及应对美国日益增加的肌肉骨骼疾病负担至关重要。