Difficulty with basic tasks such as walking a short distance or basic activities of daily living (ADL) risesrapidly with age and becomes common in old age. These disabilities have detrimental effects on quality oflife 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 conditionson later life disability. Doing so is important because the impact of these conditions on disabilty is likely slowand progressive. As a result, the full impact of these conditions on disability in the elderly is likely to beunderestimated 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) toexamine the impact of self-reported mid-life musculoskeletal conditions (arthritis and back pain) on later lifedisability (walking difficulty and difficulty with ADL). We will follow 9759 subjects who were age 51-61 whenenrolled in 1992 and will range in age from 67-77 by 2008. At baseline, subjects reported the presence ofsymptomatic arthritis and back pain. At each 2-year follow-up subjects report whether they have difficultywith 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 theimpact of mid-life musculoskeletal conditions on later life disability, the impact of other demographiccharacteristics and comorbid conditions on these relationships, and the impact of arthritis and back pain onother outcomes closely related to disabilty including death, nursing home use, caregiver burden, andretirement.
Our aims are to: (1)examine the impact of self-reported symptomatic arthritis in mid-life on laterlife disability, including difficulty performing basic activities of daily living and mobility difficulties; (2)examinethe impact of back pain in mid-life on later life disability; (3)examine whether the impact of arthritis and backpain 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 ofother comorbid medical conditions, obesity, and depression; (5)examine whether arthritis and back pain areassociated with outcomes that are common consequences of disability such as caregiver burden, nursinghome placement, and death; (6)determine whether arthritis and back pain are associated with earlyretirement and whether early retirement identifies a subset of subjects with arthritis and back pain atparticularly high risk for subsequent disability.
Showing the most recent 10 out of 199 publications
