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- Title
The Prevalence and Comorbidities of Shoulder and Neck Symptoms in an Older Population: The Johnston County Osteoarthritis Project.
- Authors
Wright, Anne; Nelson, Amanda E.; Xiaoyan A. Shi; Busby-Whitehead, Jan; Jordan, Joanne
- Abstract
Background: The increasing prevalence of neck and shoulder symptoms is particularly concerning for the geriatric population; however, little is known about associated determinants, comorbidities, level of disability, and functional status limitations. The objective of this study was to examine associations between specific comorbidities, functional outcomes, and neck and shoulder symptoms. Methods: This is a retrospective, cross-sectional analysis of neck and shoulder symptoms in white and black, men and women with an average age of 68 years, participating in the 2nd follow up visit of the Johnston County Osteoarthritis Project (N=1672, 68.7 % white, 67.5 % women). Data on self-reported musculoskeletal symptoms, comorbidities, depressive symptoms, and disability were from interviewer-administered questionnaires; functional assessments (DASH: Disability of the Arm, Shoulder, and Hand; HAQ: Health Assessment Questionnaire; grip/pinch strength, functional reach) were performed by trained staff. Descriptive statistics and frequencies for neck and shoulder symptoms were assessed and compared among severity groups. Logistic regression models for medical comorbidities and other joint symptoms, and linear regression models for functional outcomes, were adjusted for age, sex, race, and body mass index, and additionally for other joint symptoms and comorbidities. Results: Neck symptoms were reported by 12.8% of participants, shoulder symptoms were reported by 8.2%, and both neck and shoulder symptoms were reported by 12.6%. White women had the highest prevalence of neck symptoms (P≤.001), while shoulder symptoms were evenly distributed across all groups. The presence and severity of neck and shoulder symptoms were associated with lung problems, cardiovascular problems, musculoskeletal problems, cancer, diabetes mellitus, and depression in adjusted models. Most notably, lung problems (bronchitis, emphysema) and musculoskeletal problems (fibrositis, gout, tendonitis) were associated with greater than 2 times the odds of moderate/severe neck and shoulder symptoms (aOR 2.1 to 2.5 compared with no neck or shoulder symptoms), and depressive symptoms were associated with 3.3 times the odds (aOR 3.3 [95% CI 2.2, 4.9]) of moderate/severe neck and shoulder symptoms. Neck symptoms were significantly associated with pain, aching or stiffness at other sites, with a particularly strong association with shoulder symptoms (aOR 12.1). Similar findings were demonstrated for shoulder symptoms and pain, aching, or stiffness at other sites. Finally, among joint symptoms, shoulder and neck symptoms were independently associated (P<.05) with poorer functional outcome scores (DASH, HAQ, pinch, and functional reach). Conclusions: Neck and shoulder symptoms were associated with several comorbidities, increased disability, and decreased functional status in this older cohort. Approach to treatment of chronic diseases, such as lung problems, may be improved by understanding the strong associations with neck and shoulder symptoms.
- Subjects
COMORBIDITY; SHOULDER; NECK; POPULATION; OSTEOARTHRITIS
- Publication
Hawaii Journal of Medicine & Public Health, 2013, Vol 72, Issue 9, p74
- ISSN
2165-8218
- Publication type
Article