MUSCULOSKELETAL DISORDERS AS DETERMINANTS OF DISABILITY IN FINNS AGED30 YEARS OR MORE

The relationship between disability and various musculoskeletal disord ers was investigated in 7217 men and women representative of the Finni sh population aged 30 years or more. They participated in the Mini-Fin land Health Survey and were first screened by interview and questionna ire about limitations in daily activities. The outcome variables were reduced working capacity, an occasional need for assistance in daily a ctivities, and a regular need for assistance in daily activities. In a two-phase medical examination, all cases fulfilling predetermined dia gnostic criteria of musculoskeletal, cardiovascular, respiratory and m ental disorders and diabetes were recorded independently. In multivari ate logistic regression analyses, inflammatory arthritis was the stron gest determinant of all forms of disability. Osteoarthritis, especiall y in the hip, was a strong determinant of both occasional and regular need for assistance, and chronic low back pain was a strong determinan t of reduced working capacity and occasional need for assistance among those aged 30-64 years. Other musculoskeletal disorders also determin ed the prevalence disability, but these relationships were reduced by taking comorbidity into account. A low level of education and a low (l ess than 20 kg/m2) or very high (at least 35 kg/m2) body mass index re presented independent determinants of all forms of disability, and a h istory of physically strenuous work an independent determinant of redu ced working capacity, when disabling illness was adjusted for. The pro portion of all forms of disability attributable to musculoskeletal dis orders, in models including, age, sex, other disabling illness and sig nificant non-medical determinants of disability, was close to 20%. The disorders with the highest community impact were chronic low back pai n among those aged 30-64, osteoarthritis of the hips and knees and inf lammatory arthritis.