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Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(1).
Types of Musculo-Skeletal disorders in elder(2)
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
7. Low back pain
Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than men and generally occurs after the ages of 40, causing diminished quality of life of many elders(1). According to CDC, Musculoskeletal disorders (MSDs) affects over 52 millions of adults in the US alone, including 294,000 children under age 18 with some form of arthritis or rheumatic conditions(2). Rheumatoid Arthritis can induced bone loss through elevating bone resorption without increasing bone formation(4). A cross-sectional population-based study of 1042 patients with rheumatoid arthritis showed that RA patients had an increased risk of death from various causes(4a).
The Risk factors
The prevalence of Rheumatoid arthritis is proportional with the progression of age. The University of Twente study suggests age is independently associated with the levels of both acute phase reactants in early RA.(48).
In a study of 950 RA patients, the median age at the time of onset of RA according to age of the young-onset RA (YORA) and late-onset RA (LORA) is 58(49).
According to the joint study lead by the Leiden University Medical Center, Zone, expression of gene IL7R gene expression associates with longevity and healthy ageing are also found to involved risk of immune-related disease, such as RA and reduced health(50).
2. Gender and body mass index
If you are women and overweight, you are at increased risk to develop Rheumatoid Arthritis(51)(52)(54), probably due to the association between body composition BMI and inflammatory activity of in rheumatoid arthritis(55). The Korea study suggests, Middle- and old-aged women accounted for the majority of the Korean RA population, of which interfere with daily activity and employment rate(53).
Genome-wide association studies and meta-analysis indicate that several genes/loci are consistently associated with rheumatoid arthritis (RA) in European and Asian populations(40). In treatment of RA, Dr. Constantinescu F and the research team at the Virginia Commonwealth University said " (there is) racial disparities in treatment preferences for rheumatoid arthritis(56). The University of Nebraska, Omaha suggests 52 percent of African American subjects were found to be risk averse compared with 12% of the white subjects. Race remained strongly associated with risk aversion in RA(57).
Smoking is considered as one of the environment risk factor in involvement of Rheumatoid arthritis (RA) development and severity(58). The Danish study insisted that smoking exhibits other risk factors including IgM-rheumatoid factor, anti-CCP and shared epitopes in contribution to the early onset of rheumatoid arthritis(59). In fact, the medical literature was reviewed from 1985 to 2001 with the assistance of a MEDLINE showed that cigarette smoking has been increasingly shown in epidemiologic and case-control studies to be an important risk factor for both the incidence and severity of RA, especially in seropositive men. The poor habit also induce mutations or alterations in p53, a suppressor gene found in patients with RA(60).
Rheumatoid arthritis (RA) is associated to greater risk in the first degree relatives in familial clustering, mothers confer susceptibility to RA on their offspring more often than fathers(61). According to the data on patients with RA were ascertained through the nationwide Swedish Patient Register of 88,639, the clinical Swedish Rheumatology Quality Register of 11,519, risk of RA are same in both sex but Familial factors is found to be overlap between seropositive RA and seronegative RA(62).
Certain vaccines may cause Rheumatoid Arthritis(65). But there is no statistically significant association between exposure to vaccine and onset of RA, according to the Kaiser Permanente Vaccine Study Center(64).
7. Other risk factors
Dr. Oliver JE and Dr. Silman AJ. in the study risk factors are that lead to the development of rheumatoid arthritis (RA). suggest diets high in caffeine, low in antioxidants, high in red meat, changes in the female hormonal environment such as in pregnancy, breastfeeding and the use of the oral contraceptive (OC) pill, cigarette smoking and passive inhalation of smoke may also contribute to an increased risk of RA(63).
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(1) 8 Areas of Age-Related Change(NIH)
(2) Arthritis-Related Statistics(CDC)
(3) Valgus deformities of the feet and characteristics of gait in patients who have rheumatoid arthritis by Keenan MA1, Peabody TD, Gronley JK, Perry J.(PubMed)
(4) Serum Sclerostin Level Among Egyptian Rheumatoid Arthritis Patients: Relation to Disease Activity ,Bone Mineral Density and Radiological Grading by Mehaney DA, Eissa M, Anwar S, El-Din SF(PubMed)
(4a) Death rates and causes of death in patients with rheumatoid arthritis: a population-based study by Sihvonen S1, Korpela M, Laippala P, Mustonen J, Pasternack A(PubMed)
(48) How age and sex affect the erythrocyte sedimentation rate and C-reactive protein in early rheumatoid arthritis by Siemons L1, Ten Klooster PM, Vonkeman HE, van Riel PL, Glas CA, van de Laar MA.(PubMed)
(49) Age at onset determines severity and choice of treatment in early rheumatoid arthritis: a prospective study by Innala L, Berglin E, Möller B, Ljung L, Smedby T, Södergren A, Magnusson S, Rantapää-Dahlqvist S, Wållberg-Jonsson S.(PubMed)
(50) IL7R gene expression network associates with human healthy ageing by Passtoors WM1, van den Akker EB2, Deelen J3, Maier AB4, van der Breggen R1, Jansen R5, Trompet S6, van Heemst D7, Derhovanessian E8, Pawelec G8, van Ommen GJ9, Slagboom PE3, Beekman M3.(PubMed)
(51) Gender, body mass index and rheumatoid arthritis disease activity: results from the QUEST-RA Study by Jawaheer D, Olsen J, Lahiff M, Forsberg S, Lähteenmäki J, da Silveira IG, Rocha FA, Magalhães Laurindo IM, Henrique da Mota LM, Drosos AA, Murphy E,Sheehy C, Quirke E, Cutolo M, Rexhepi S, Dadoniene J, Verstappen SM, Sokka T; QUEST-RA.(PubMed)
(52) Women, men, and rheumatoid arthritis: analyses of disease activity, disease characteristics, and treatments in the QUEST-RA study by Sokka T, Toloza S, Cutolo M, Kautiainen H, Makinen H, Gogus F, Skakic V, Badsha H, Peets T, Baranauskaite A, Géher P, Ujfalussy I, Skopouli FN, Mavrommati M, Alten R, Pohl C, Sibilia J, Stancati A, Salaffi F, Romanowski W, Zarowny-Wierzbinska D, Henrohn D, Bresnihan B, Minnock P, Knudsen LS, Jacobs JW,Calvo-Alen J, Lazovskis J, Pinheiro Gda R, Karateev D, Andersone D, Rexhepi S, Yazici Y, Pincus T; QUEST-RA Group.(PubMed)
(53) Socioeconomic and employment status of patients with rheumatoid arthritis in Korea by Kwon JM1, Rhee J, Ku H, Lee EK.(PubMed)
(54) Body mass index and the risk of rheumatoid arthritis: a systematic review and dose-response meta-analysis by Qin B1, Yang M2,3, Fu H4, Ma N5, Wei T6, Tang Q7, Hu Z8, Liang Y9, Yang Z10, Zhong R11.(PubMed)
(55) Association between body composition and inflammatory activity in rheumatoid arthritis. A systematic review.[Article in English, Spanish]by Alvarez-Nemegyei J1, Buenfil-Relloy FA2, Pacheco-Pantoja EL3.(PubMed)
(56) Racial disparities in treatment preferences for rheumatoid arthritis by Constantinescu F1, Goucher S, Weinstein A, Fraenkel L.(PubMed)
(57) The association of race and ethnicity with disease expression in male US veterans with rheumatoid arthritis by Mikuls TR1, Kazi S, Cipher D, Hooker R, Kerr GS, Richards JS, Cannon GW.(PubMed)
(58) Smoking and rheumatoid arthritis by Chang K1, Yang SM2, Kim SH3, Han KH4, Park SJ5, Shin JI2.(PubMed)
(59) [Smoking--a risk factor for rheumatoid arthritis development].[Article in Danish] by Christensen AF1, Lindegaard HM, Junker P.(PubMed)
(60) Cigarette smoking and rheumatoid arthritis by Albano SA1, Santana-Sahagun E, Weisman MH.(PubMed)
(61) Family history as a risk factor for rheumatoid arthritis: a case-control study by Koumantaki Y1, Giziaki E, Linos A, Kontomerkos A, Kaklamanis P, Vaiopoulos G, Mandas J, Kaklamani E.(PubMed)
(62) Familial risks and heritability of rheumatoid arthritis: role of rheumatoid factor/anti-citrullinated protein antibody status, number and type of affected relatives, sex, and age by Frisell T1, Holmqvist M, Källberg H, Klareskog L, Alfredsson L, Askling J.(PubMed)
(63) Risk factors for the development of rheumatoid arthritis by Oliver JE1, Silman AJ.(PubMed)