Comorbidity of musculoskeletal disorders in patients of elderly groups

N.O. Khovasova, A.V. Naumov, O.N. Tkacheva, V.I. Ruzanova Pirogov Russian National Research Medical University, Moscow 

Background: comorbidity is the presence of two or more chronic diseases in one patient. In senile age, geriatric syndromes play an important role in the comorbidity structure. One of the common comorbidity models are the musculoskeletal disorders.

Aim: to assess the prevalence and structure of geriatric syndromes in patients with musculoskeletal comorbidity.

Patients and Methods: the study included 1003 patients (age 77.6±8.2 years, 79.9% female patients) who were hospitalized in the geriatric department. All patients had chronic diseases, the Charlson Comorbidity Index was 5.82±1.8 points. The complaints, anamnesis and general examination data from all patients were collected, as well as the presence of age-related diseases of the musculoskeletal system (MSS) and a comprehensive geriatric assessment (CGA) were evaluated. To assess the effect of falls on the geriatric state of patients with musculoskeletal disorders, the patients with osteoarthritis (OA) were isolated and divided into 2 groups depending on the falls: group 1 — with falls (n=350), group 2 — without falls (n=347).

Results: 823 (82.1%) patients had musculoskeletal disorders. 77 (9.4%) of patients were diagnosed with one musculoskeletal disorder, 460 (55.9%) — with a combination of two disorders, 286 (34.7%) — with three or more. All patients were diagnosed with geriatric syndromes: the most common among them were balance disorders (71.1%), functional decline (59.9%), polypragmasia (50.9%), sleep disorders (50.1%), vision deficiency (48.6%), fear of falling (48.2%), senile asthenia (48.1%) and falls (46.9%). To CGA showed that in patients with OA and falls, the results of tandem gait test, gait velocity, hand dynamometry in women, gait-stair-gower-chair score, timed up & go test, FRAX algorithm, and MMSE were significantly worse than in patients with OA and without falls.

Conclusion: Comorbidity in elderly patients is a heterogeneous condition, including chronic diseases and geriatric syndromes. One common type of comorbidity in the elderly is musculoskeletal comorbidity. Falls are a significant factor in the deterioration of mobility in patients with OA.

Keywords: comorbidity, musculoskeletal disorders, osteoarthritis, geriatric syndrome, falls, complex geriatric assessment.

For citation: Khovasova N.O., Naumov A.V., Tkacheva O.N., Ruzanova V.I. Comorbidity of musculoskeletal disorders in patients of elderly groups. RMJ. 2022;6:7–11.