Musculoskeletal disability among elderly people in the community

Objectives: To determine the prevalence and determinants of disability among elderly people living in the community. Design: A cross-sectional postal questionnaire survey. Setting: Northern Sydney Area Health Service. Participants: 1527 residents (622 men and 905 women) aged 65 years and over. Main outcome measures: Self-reported chronic illnesses, injuries or conditions; difficulties with activities of daily living assessed by the Health Assessment Questionnaire (HAQ); and home modification and use of functional aids. Results: "Arthritis or rheumatism" was the leading long term condition, reported by 59.5%, 55.8% and 59.7% of women and 40.5%, 47.0% and 43.6% of men in the three age groups (65-74, 75-84 and 85 years and over), respectively. The back, neck and knees were the most common sites of pain and stiffness. Of the respondents, 23.4% of women and 24.3% of men reported regularly taking nonsteroidal anti-inflammatory drugs. Impaired performance of activities of daily living increased with age, with 53.9%, 70.7% and 89.6% of women and 37.6%, 63.6% and 73.2% of men in the respective age groups reporting at least some difficulty (HAQ score > 0). Multivariate analysis found self-reported poor general health, loss of a limb, arthritis or rheumatism, other long term conditions restricting physical activity, impaired vision, female sex, and age to be significant predictors of disability as measured by HAQ scores. Only 13.9% of women and 9.4% of men had made changes to their home. Functional aids were used by 27.7%, 37.3% and 65.9% of women and 15.6%, 33.4% and 59.1% of men in the respective age groups. Conclusion: Arthritis and rheumatism were the most prevalent chronic conditions among elderly people in the community, and were significantly associated with difficulty with performing activities of daily living, after controlling for effects of age, sex and other chronic conditions.