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Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

Musculoskeletal comorbidities in cardiovascular disease, diabetes and respiratory disease: the impact on activity limitations; a representative population-based study

Authors: Morgan Slater, Anthony V Perruccio, Elizabeth M Badley

Published in: BMC Public Health | Issue 1/2011

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Abstract

Background

The purpose of this study was to quantify the contribution of comorbidity to activity limitations in populations with chronic cardiovascular disease, diabetes or respiratory disease (index conditions), with emphasis on musculoskeletal comorbidity (arthritis or back problems).

Methods

Analysis of the 2005 Canadian Community Health Survey 3.1 (age 20+ years, n = 115,915). Prevalence ratios for activity limitations in people with the index conditions and co-occurring musculoskeletal disease, adjusted for age, gender, and socioeconomic factors, were used to estimate population associated fractions (PAF).

Results

Comorbid arthritis and back problems significantly increased the risk of activity limitations across all index conditions with prevalence ratios of 1.60 and 1.46 for cardiovascular disease, 1.51 and 1.36 for diabetes, and 1.38 and 1.44 for respiratory disease for arthritis and back problems respectively. Arthritis and back problems accounted for at least 13% and 9% of activity limitations in the index populations.

Conclusions

While chronic musculoskeletal conditions are not always considered priorities in chronic disease prevention, they account for a substantial proportion of activity restrictions seen in people with cardiovascular disease, diabetes and respiratory disease, with implications for prevention and control strategies.
Literature
2.
go back to reference Salihu HM, Bonnema SM, Alio AP: Obesity: What is an elderly population growing into?. Maturitas. 2009, 63: 7-12. 10.1016/j.maturitas.2009.02.010.CrossRefPubMed Salihu HM, Bonnema SM, Alio AP: Obesity: What is an elderly population growing into?. Maturitas. 2009, 63: 7-12. 10.1016/j.maturitas.2009.02.010.CrossRefPubMed
3.
go back to reference Adams SG, Smith PK, Allan PF, Anzueto A, Pugh JA, Cornell JE: Systematic review of the chronic care model in chronic obstructive pulmonary disease prevention and management. Arch Intern Med. 2007, 167: 551-561. 10.1001/archinte.167.6.551.CrossRefPubMed Adams SG, Smith PK, Allan PF, Anzueto A, Pugh JA, Cornell JE: Systematic review of the chronic care model in chronic obstructive pulmonary disease prevention and management. Arch Intern Med. 2007, 167: 551-561. 10.1001/archinte.167.6.551.CrossRefPubMed
4.
go back to reference Vogeli C, Shields AE, Lee TA, Gibson TB, Marder WD, Weiss KB, Blumenthal D: Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. J Gen Intern Med. 2007, 22 (Suppl 3): 391-395. 10.1007/s11606-007-0322-1.CrossRefPubMedPubMedCentral Vogeli C, Shields AE, Lee TA, Gibson TB, Marder WD, Weiss KB, Blumenthal D: Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. J Gen Intern Med. 2007, 22 (Suppl 3): 391-395. 10.1007/s11606-007-0322-1.CrossRefPubMedPubMedCentral
5.
6.
go back to reference Gijsen R, Hoeymans N, Schellevis FG, Ruwaard D, Satariano WA, van den Bos GA: Causes and consequences of comorbidity: a review. J Clin Epidemiol. 2001, 54: 661-674. 10.1016/S0895-4356(00)00363-2.CrossRefPubMed Gijsen R, Hoeymans N, Schellevis FG, Ruwaard D, Satariano WA, van den Bos GA: Causes and consequences of comorbidity: a review. J Clin Epidemiol. 2001, 54: 661-674. 10.1016/S0895-4356(00)00363-2.CrossRefPubMed
7.
go back to reference Caughey GE, Vitry AI, Gilbert AL, Roughead EE: Prevalence of comorbidity of chronic diseases in Australia. BMC Public Health. 2008, 8: 221-10.1186/1471-2458-8-221.CrossRefPubMedPubMedCentral Caughey GE, Vitry AI, Gilbert AL, Roughead EE: Prevalence of comorbidity of chronic diseases in Australia. BMC Public Health. 2008, 8: 221-10.1186/1471-2458-8-221.CrossRefPubMedPubMedCentral
8.
go back to reference Fried LP, Guralnik JM: Disability in older adults: evidence regarding significance, etiology, and risk. J Am Geriatr Soc. 1997, 45: 92-100.CrossRefPubMed Fried LP, Guralnik JM: Disability in older adults: evidence regarding significance, etiology, and risk. J Am Geriatr Soc. 1997, 45: 92-100.CrossRefPubMed
9.
go back to reference Schellevis FG, van d V, van de LE, van Eijk JT, van Weel C: Comorbidity of chronic diseases in general practice. J Clin Epidemiol. 1993, 46: 469-473. 10.1016/0895-4356(93)90024-U.CrossRefPubMed Schellevis FG, van d V, van de LE, van Eijk JT, van Weel C: Comorbidity of chronic diseases in general practice. J Clin Epidemiol. 1993, 46: 469-473. 10.1016/0895-4356(93)90024-U.CrossRefPubMed
10.
go back to reference Siebens HC: Musculoskeletal problems as comorbidities. Am J Phys Med Rehabil. 2007, 86: S69-S78. 10.1097/PHM.0b013e31802ba581.CrossRefPubMed Siebens HC: Musculoskeletal problems as comorbidities. Am J Phys Med Rehabil. 2007, 86: S69-S78. 10.1097/PHM.0b013e31802ba581.CrossRefPubMed
11.
go back to reference Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation--United States, 2003-2005. MMWR Morb Mortal Wkly Rep. 2006, 55: 1089-1092. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation--United States, 2003-2005. MMWR Morb Mortal Wkly Rep. 2006, 55: 1089-1092.
12.
go back to reference Badley EM, Rasooly I, Webster GK: Relative importance of musculoskeletal disorders as a cause of chronic health problems, disability, and health care utilization: findings from the 1990 Ontario Health Survey. J Rheumatol. 1994, 21: 505-514.PubMed Badley EM, Rasooly I, Webster GK: Relative importance of musculoskeletal disorders as a cause of chronic health problems, disability, and health care utilization: findings from the 1990 Ontario Health Survey. J Rheumatol. 1994, 21: 505-514.PubMed
13.
go back to reference Canadian Community Health Survey (CCHS) Cycle 3.1(2005) Public Use Microdata Files User Guide. Canadian Community Health Survey (CCHS) Cycle 3.1(2005) Public Use Microdata Files User Guide.
14.
go back to reference Perruccio AV, Power JD, Badley EM: The relative impact of 13 chronic conditions across three different outcomes. J Epidemiol Community Health. 2007, 61: 1056-1061. 10.1136/jech.2006.047308.CrossRefPubMedPubMedCentral Perruccio AV, Power JD, Badley EM: The relative impact of 13 chronic conditions across three different outcomes. J Epidemiol Community Health. 2007, 61: 1056-1061. 10.1136/jech.2006.047308.CrossRefPubMedPubMedCentral
15.
go back to reference Zou G: A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004, 159: 702-706. 10.1093/aje/kwh090.CrossRefPubMed Zou G: A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004, 159: 702-706. 10.1093/aje/kwh090.CrossRefPubMed
16.
go back to reference Barros AJ, Hirakata VN: Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003, 3: 21-10.1186/1471-2288-3-21.CrossRefPubMedPubMedCentral Barros AJ, Hirakata VN: Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003, 3: 21-10.1186/1471-2288-3-21.CrossRefPubMedPubMedCentral
17.
go back to reference Lawton MP, Brody EM: Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969, 9: 179-186.CrossRefPubMed Lawton MP, Brody EM: Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969, 9: 179-186.CrossRefPubMed
18.
go back to reference Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW, Kelly-Hayes M, Wolf PA, Kreger BE, Kannel WB: The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health. 1994, 84: 351-358. 10.2105/AJPH.84.3.351.CrossRefPubMedPubMedCentral Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW, Kelly-Hayes M, Wolf PA, Kreger BE, Kannel WB: The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health. 1994, 84: 351-358. 10.2105/AJPH.84.3.351.CrossRefPubMedPubMedCentral
19.
go back to reference Verbrugge LM, Patrick DL: Seven chronic conditions: their impact on US adults' activity levels and use of medical services. Am J Public Health. 1995, 85: 173-182. 10.2105/AJPH.85.2.173.CrossRefPubMedPubMedCentral Verbrugge LM, Patrick DL: Seven chronic conditions: their impact on US adults' activity levels and use of medical services. Am J Public Health. 1995, 85: 173-182. 10.2105/AJPH.85.2.173.CrossRefPubMedPubMedCentral
20.
go back to reference Picavet HS, van den Bos GA: The contribution of six chronic conditions to the total burden of mobility disability in the Dutch population. Am J Public Health. 1997, 87: 1680-1682. 10.2105/AJPH.87.10.1680.CrossRefPubMedPubMedCentral Picavet HS, van den Bos GA: The contribution of six chronic conditions to the total burden of mobility disability in the Dutch population. Am J Public Health. 1997, 87: 1680-1682. 10.2105/AJPH.87.10.1680.CrossRefPubMedPubMedCentral
21.
go back to reference Griffith L, Raina P, Wu H, Zhu B, Stathokostas L: Population attributable risk for functional disability associated with chronic conditions in Canadian older adults. Age Ageing. 2010, 39: 738-745. 10.1093/ageing/afq105.CrossRefPubMed Griffith L, Raina P, Wu H, Zhu B, Stathokostas L: Population attributable risk for functional disability associated with chronic conditions in Canadian older adults. Age Ageing. 2010, 39: 738-745. 10.1093/ageing/afq105.CrossRefPubMed
22.
go back to reference Manuel DG, Schultz SE: Diabetes Health Status and Risk Factors. Diabetes in Ontario: An ICES Practice Atlas. Edited by: Hux J, Booth G, Slaughter P, Laupacis A. 2003, Institute for Clinical Evaluative Sciences, 4: 77-4. 94 Manuel DG, Schultz SE: Diabetes Health Status and Risk Factors. Diabetes in Ontario: An ICES Practice Atlas. Edited by: Hux J, Booth G, Slaughter P, Laupacis A. 2003, Institute for Clinical Evaluative Sciences, 4: 77-4. 94
23.
go back to reference Tanuseputro P, Manuel DG, Leung M, Nguyen K, Johansen H: Risk factors for cardiovascular disease in Canada. CCORT Canadian Cardiovascular Atlas. Edited by: Tu JV, Ghali WA, Pilote L, Brien S. 2006, Pulsus Group Inc and Institute for Clinical Evaluative Sciences, 30-40. Tanuseputro P, Manuel DG, Leung M, Nguyen K, Johansen H: Risk factors for cardiovascular disease in Canada. CCORT Canadian Cardiovascular Atlas. Edited by: Tu JV, Ghali WA, Pilote L, Brien S. 2006, Pulsus Group Inc and Institute for Clinical Evaluative Sciences, 30-40.
24.
go back to reference Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH: The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009, 9: 88-10.1186/1471-2458-9-88.CrossRefPubMedPubMedCentral Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH: The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009, 9: 88-10.1186/1471-2458-9-88.CrossRefPubMedPubMedCentral
25.
go back to reference Ells LJ, Lang R, Shield JP, Wilkinson JR, Lidstone JS, Coulton S, Summerbell CD: Obesity and disabil. Obes Rev. 2006, 7: 341-345. 10.1111/j.1467-789X.2006.00233.x.CrossRefPubMed Ells LJ, Lang R, Shield JP, Wilkinson JR, Lidstone JS, Coulton S, Summerbell CD: Obesity and disabil. Obes Rev. 2006, 7: 341-345. 10.1111/j.1467-789X.2006.00233.x.CrossRefPubMed
26.
go back to reference Liou TH, Pi-Sunyer FX, Laferrere B: Physical disability and obesity. Nutr Rev. 2005, 63: 321-331. 10.1111/j.1753-4887.2005.tb00110.x.CrossRefPubMed Liou TH, Pi-Sunyer FX, Laferrere B: Physical disability and obesity. Nutr Rev. 2005, 63: 321-331. 10.1111/j.1753-4887.2005.tb00110.x.CrossRefPubMed
27.
go back to reference Canada Mortgage and Housing Corporation: A socio-demographic profile of Canadians experiencing health or activity limitations. Ottawa. 1992 Canada Mortgage and Housing Corporation: A socio-demographic profile of Canadians experiencing health or activity limitations. Ottawa. 1992
28.
go back to reference Verbrugge LM, Juarez L: Arthritis disability and heart disease disability. Arthritis Rheum. 2008, 59: 1445-1457. 10.1002/art.24107.CrossRefPubMed Verbrugge LM, Juarez L: Arthritis disability and heart disease disability. Arthritis Rheum. 2008, 59: 1445-1457. 10.1002/art.24107.CrossRefPubMed
29.
go back to reference Hootman JM, Macera CA, Ham SA, Helmick CG, Sniezek JE: Physical activity levels among the general US adult population and in adults with and without arthritis. Arthritis Rheum. 2003, 49: 129-135. 10.1002/art.10911.CrossRefPubMed Hootman JM, Macera CA, Ham SA, Helmick CG, Sniezek JE: Physical activity levels among the general US adult population and in adults with and without arthritis. Arthritis Rheum. 2003, 49: 129-135. 10.1002/art.10911.CrossRefPubMed
30.
go back to reference Arthritis as a potential barrier to physical activity among adults with heart disease--United States, 2005 and 2007. MMWR Morb Mortal Wkly Rep. 2009, 58: 165-169. Arthritis as a potential barrier to physical activity among adults with heart disease--United States, 2005 and 2007. MMWR Morb Mortal Wkly Rep. 2009, 58: 165-169.
31.
go back to reference Arthritis as a potential barrier to physical activity among adults with diabetes--United States, 2005 and 2007. MMWR Morb Mortal Wkly Rep. 2008, 57: 486-489. Arthritis as a potential barrier to physical activity among adults with diabetes--United States, 2005 and 2007. MMWR Morb Mortal Wkly Rep. 2008, 57: 486-489.
32.
go back to reference McDougall J, Miller LT: Measuring chronic health condition and disability as distinct concepts in national surveys of school-aged children in Canada: a comprehensive review with recommendations based on the ICD-10 and ICF. Disabil Rehabil. 2003, 25: 922-939. 10.1080/0963828031000122249.CrossRefPubMed McDougall J, Miller LT: Measuring chronic health condition and disability as distinct concepts in national surveys of school-aged children in Canada: a comprehensive review with recommendations based on the ICD-10 and ICF. Disabil Rehabil. 2003, 25: 922-939. 10.1080/0963828031000122249.CrossRefPubMed
33.
go back to reference Heliovaara M, Aromaa A, Klaukka T, Knekt P, Joukamaa M, Impivaara O: Reliability and validity of interview data on chronic diseases. The Mini-Finland Health Survey. J Clin Epidemiol. 1993, 46: 181-191. 10.1016/0895-4356(93)90056-7.CrossRefPubMed Heliovaara M, Aromaa A, Klaukka T, Knekt P, Joukamaa M, Impivaara O: Reliability and validity of interview data on chronic diseases. The Mini-Finland Health Survey. J Clin Epidemiol. 1993, 46: 181-191. 10.1016/0895-4356(93)90056-7.CrossRefPubMed
34.
go back to reference Beckett M, Weinstein M, Goldman N, Yu-Hsuan L: Do health interview surveys yield reliable data on chronic illness among older respondents?. Am J Epidemiol. 2000, 151: 315-323.CrossRefPubMed Beckett M, Weinstein M, Goldman N, Yu-Hsuan L: Do health interview surveys yield reliable data on chronic illness among older respondents?. Am J Epidemiol. 2000, 151: 315-323.CrossRefPubMed
35.
go back to reference Haapanen N, Miilunpalo S, Pasanen M, Oja P, Vuori I: Agreement between questionnaire data and medical records of chronic diseases in middle-aged and elderly Finnish men and women. Am J Epidemiol. 1997, 145: 762-769.CrossRefPubMed Haapanen N, Miilunpalo S, Pasanen M, Oja P, Vuori I: Agreement between questionnaire data and medical records of chronic diseases in middle-aged and elderly Finnish men and women. Am J Epidemiol. 1997, 145: 762-769.CrossRefPubMed
36.
go back to reference Stein MB, Cox BJ, Afifi TO, Belik SL, Sareen J: Does co-morbid depressive illness magnify the impact of chronic physical illness? A population-based perspective. Psychol Med. 2006, 36: 587-596. 10.1017/S0033291706007239.CrossRefPubMed Stein MB, Cox BJ, Afifi TO, Belik SL, Sareen J: Does co-morbid depressive illness magnify the impact of chronic physical illness? A population-based perspective. Psychol Med. 2006, 36: 587-596. 10.1017/S0033291706007239.CrossRefPubMed
37.
go back to reference Hill CL, Gill T, Taylor AW, Daly A, Grande ED, Adams RJ: Psychological factors and quality of life in arthritis: a population-based study. Clin Rheumatol. 2007, 26: 1049-1054. 10.1007/s10067-006-0439-3.CrossRefPubMed Hill CL, Gill T, Taylor AW, Daly A, Grande ED, Adams RJ: Psychological factors and quality of life in arthritis: a population-based study. Clin Rheumatol. 2007, 26: 1049-1054. 10.1007/s10067-006-0439-3.CrossRefPubMed
38.
go back to reference Ford DE: Optimizing outcomes for patients with depression and chronic medical illnesses. Am J Med. 2008, 121: S38-S44. 10.1016/j.amjmed.2008.09.012.CrossRefPubMed Ford DE: Optimizing outcomes for patients with depression and chronic medical illnesses. Am J Med. 2008, 121: S38-S44. 10.1016/j.amjmed.2008.09.012.CrossRefPubMed
39.
go back to reference Marzolini S, Candelaria H, Oh P: Prevalence and impact of musculoskeletal comorbidities in cardiac rehabilitation. J Cardiopulm Rehabil Prev. 2010, 30: 391-400.CrossRefPubMed Marzolini S, Candelaria H, Oh P: Prevalence and impact of musculoskeletal comorbidities in cardiac rehabilitation. J Cardiopulm Rehabil Prev. 2010, 30: 391-400.CrossRefPubMed
40.
go back to reference Dziedzic K, Jordan JL, Foster NE: Land- and water-based exercise therapies for musculoskeletal conditions. Best Pract Res Clin Rheumatol. 2008, 22: 407-418. 10.1016/j.berh.2007.11.002.CrossRefPubMed Dziedzic K, Jordan JL, Foster NE: Land- and water-based exercise therapies for musculoskeletal conditions. Best Pract Res Clin Rheumatol. 2008, 22: 407-418. 10.1016/j.berh.2007.11.002.CrossRefPubMed
Metadata
Title
Musculoskeletal comorbidities in cardiovascular disease, diabetes and respiratory disease: the impact on activity limitations; a representative population-based study
Authors
Morgan Slater
Anthony V Perruccio
Elizabeth M Badley
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-77

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