National physical activity recommendations for older Australians: Discussion Document

4.9 Musculo-skeletal health

The National Ageing Research Institute was commissioned by The Department of Health and Ageing to review the evidence and develop physical activity recommendations for older people.

Page last updated: 01 February 2011

Joint problems and disorders of the bones, muscles and their attachments to each other are categorised as musculoskeletal conditions. The National Health Priority Area’s (NHPA) focus is on osteoarthritis, rheumatoid arthritis and osteoporosis. These conditions contribute significantly to the burden of disease at an individual and societal level. Arthritis and musculoskeletal conditions were the second most frequently managed problem (17 per 100 encounters) by GPs in 2003-04, accounting for almost 12% of all problems managed that year. According to the 2004-05 National Health Survey, over three million adult Australians reported arthritis and musculoskeletal conditions (Australian Bureau of Statistics 2006).

Osteoarthritis is one of the most common forms of arthritis, a term given to the group of degenerative musculoskeletal conditions where there is joint inflammation causing pain, stiffness, disability and deformity. Osteoarthritis is of relevance to older people’s health as it commonly develops between the ages of 45 to 90 years. In the 2004-05 National Health Survey, 15% of respondents (18% of the females and 13% of the males) reported arthritis. Half of these cases (51%) were osteoarthritis, 16% were rheumatoid arthritis and 39% reported they had another type of arthritis or didn't know the type of arthritis they had. The majority (78%) reported that a doctor or nurse had diagnosed their condition. The prevalence of arthritis increased with age from less than 1% of people aged < 25years to 49% of people aged 65 years and over. The (age standardised) proportion of people reporting arthritis increased from 14% in 2001 to 15% in 2004–05. Part of this increase is likely to be the result of changes in survey methodologies between the two data collection periods.

Rheumatoid arthritis is a chronic inflammatory autoimmune disease involving joint swelling and destruction. Rheumatoid arthritis commonly affects the hand joints producing deformities. Rheumatoid arthritis commonly develops between the ages of 25 and 50: prevalence increases markedly with age. In the 2004-05 National Health Survey, 491,000 people reported having rheumatoid arthritis (Australian Bureau of Statistics 2006).

Osteoporosis is a musculoskeletal disorder where the bone density thins and weakens, resulting in an increased risk of fracture, particularly in the spine, hip and wrist regions. In the 2004-05 National Health Survey, 3% of respondents reported osteoporosis: 1% of males and 5% of females. As with arthritis, the proportion of people with osteoporosis increased with age, from less than 1% of those aged < 25 years to 14% of those aged 65 years and over (Australian Bureau of Statistics 2006). The prevalence was greatest in those aged 75 years and over.

Musculoskeletal health and physical activity

Physical activity has been shown to produce improvements in function and strength and reduce pain in those with musculoskeletal conditions (Roddy, Zhang et al. 2005). Illustrations of the types of physical activity programs used will be discussed in Chapter 9.
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