Original Research Prevalence and correlates of musculoskeletal pain in Chinese elderly and the impact on 4-year physical function and quality of life J. Woo a, * , J. Leung b , E. Lau c a Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, NT, Hong Kong b Jockey Club Centre for Osteoporosis Care and Control, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong c Hong Kong Orthopaedic and Osteoporosis Centre for Treatment and Research, Hong Kong article info Article history: Received 19 February 2009 Received in revised form 25 June 2009 Accepted 15 July 2009 Available online 25 August 2009 Keywords: Musculoskeletal pain Elderly Physical function Quality of life summary Objective: To examine the prevalence, correlates and prospective impact of musculoskeletal pain on physical and psychological function in a population health survey of elderly Chinese men and women. Study design: Cohort study. Methods: Four thousand men and women, aged 65 years and over, living in the community in Hong Kong took part in this study. A questionnaire to determine demographics, socio-economic status, medical history, smoking, alcohol intake and level of physical activity was administered by an interviewer. Participants were asked about the presence of pain in the back, neck, hip and knee in the past 12 months. They were re-interviewed after 4 years of follow-up to document physical performance measures, psychological function and occurrence of falls, fractures and mortality. Results: Overall, back pain was most prevalent (48%), followed by knee (31%), neck (22.5%) and hip (8.9%) pain; the values was nearly twice as high in women compared with men for all sites. The presence of pain was not correlated with age, but was associated with various measures of socio-economic status as well as comorbidities. Baseline prevalence of pain was related to physical performance and quality-of-life measures, and fracture incidence after 4 years of follow-up. Conclusion: Musculoskeletal pain is prevalent among elderly men and women, being much higher in the latter, giving rise to considerable functional and psychological impairments. Osteoporosis and osteoar- thritis are likely to be the main underlying causes. The condition may be considered part of the frailty syndrome, and in this context, prevention and management represent major public health challenges. Ó 2009 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. Introduction The prevalence of musculoskeletal pain in elderly populations has been observed to be high, with varying impact on physical and psychological function. 1–6 Although arthritis or osteoporosis may be the underlying cause of pain, the impact of pain may have a direct effect independent of disability due to the underlying pathology. 7 Ethnic and gender differences have been observed in the pattern of joints affected by degenerative arthritic processes, and socio-economic status has also been found to be an associated factor. 8–10 Furthermore, since pain is a subjective characteristic, differential responses to pain may influence the physical and psychological consequences. Responses may also vary according to age, ethnicity, gender or the site of pain. 11–16 Population data regarding musculoskeletal pain in men is relatively sparse compared with that for women. Since musculoskeletal pain could give rise to substantial morbidity in elderly populations, this study examined its prevalence and correlates, as well as its prospective impact on physical and psychological function, in a population health survey of 2000 elderly Chinese men and 2000 elderly women in Hong Kong. It was hypothesized that musculoskeletal pain is very common in elderly people, and is an important predictor of impairment in physical and psychological function. Methods Participants Four thousand men and women, aged 65 years and over, living in the community in the north-east region of the New Territories of Hong Kong were invited to attend a health check at the School of Public Health of the Chinese University of Hong Kong, by placing * Corresponding author. Tel.: þ852 26323493; fax: þ852 26373852. E-mail address: jeanwoowong@cuhk.edu.hk (J. Woo). Contents lists available at ScienceDirect Public Health journal homepage: www.elsevierhealth.com/journals/pubh 0033-3506/$ – see front matter Ó 2009 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.puhe.2009.07.006 Public Health 123 (2009) 549–556