Musculoskeletal Problems: An Under-recognized Determinant of Quality of Life

There is nothing like waking up in the morning with a stiff back and difficulty moving to remind oneself that arthritic disorders are an important factor in the quality of our everyday lives. Over the years I have frequently reminded our readers that among older adults living in the community, musculoskeletal problems are a more important determinant of quality of life than are cardiac diseases such as angina. The high prevalence of arthritic complaints among older adults makes arthritis the single most important medical factor in determining the quality of life for older adults. Fortunately, the once nihilistic approach to arthritis in older people is changing with newer therapeutic modalities and surgical options. Hopefully, the days of older patients simply being told, “You’re 90 years old: what do you expect?” are being phased out and replaced by, “You’re 90 years old: we will have to see what can help with your problems.”

Our CME article this month concerns probably the most common arthritic condition among older people, “Osteoarthritis of the Knee.” This learning module has been created by Drs. Kevin D. Gross and David J. Hunter. Dr. Peter G. Passias and Dr. James V. Bono review one of the most successful modern surgical procedures in their article “Total Hip Arthroplasty in the Older Population.” Although we usually think that inflammatory arthritis is a syndrome of younger adults, it can be an important cause of morbidity in older adults as well. Tara Snelgrove and Dr. Proton Rahman review this important topic in their article “Inflammatory Polyarthritis in the Older Adult.”

We also have our usual collection of diverse articles. The interesting area of gender difference in medicine is explored in this issue’s Cardiovascular column and addresses “Gender and Congestive Heart Failure” by Dr. Silja Majahalme. An internationally renowned group from the Centre for Research in Neurodegenerative Diseases at the University of Toronto, Drs. Yosuke Wakutani, Peter St. George-Hyslop, and Ekaterina Rogaeva discuss “The Genetic Profile of Dementia.”

Our cancer column addresses “Cancer Chemotherapy in the Older Cancer Patient” and is contributed by Dr. Lodovico Balducci. Finally, the cancer theme is continued in the article “Epidemiology of Colorectal Cancer and Aging” by Dr. Maida J. Sewitch and Caroline Fournier.

Enjoy this issue,
Barry Goldlist