Musculoskeletal Multimorbidity Burden and Trajectory in Relation to Later-Life Holistic Well-Being Among Middle-Aged and Elderly Individuals: A Prospective Study

Objectives: Understanding the patterns and implications of coexisting musculoskeletal conditions is crucial for developing effective management strategies and improving care for older adults. This study aimed to examine the associations between musculoskeletal multimorbidity burden and trajectory and holistic well-being among middle-aged and older adults.

Methods: This prospective study employed data from nine consecutive waves of the English Longitudinal Study of Aging (ELSA), spanning 2002-2018. We used latent class trajectory models (LCTM) to identify groups based on changes in musculoskeletal multimorbidity status. Subsequently, we employed linear mixed models to investigate the associations between musculoskeletal disease burden, trajectory groups, and seven dimensions of holistic well-being: Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), depression, memory, loneliness, social interactions, and life satisfaction.

Results: In total, 5272 participants (mean age: 71.9 years; SD: 8.9) were included in the final analysis. Four distinct trajectories were identified: a low-burden group (48.37%), an emerging group (14.76%), a moderate-burden group (26.00%), and a persistent burden group (10.87%). After adjustment, the findings demonstrate that the musculoskeletal disorder burden significantly impacts ADLs, depression, memory, social interactions, and life satisfaction in middle-aged and older adults, with minor effects on IADLs and loneliness. Moreover, with the escalation of the burden, its impact significantly intensifies (p for trend is < 0.001). Compared with the low-burden group, participants in both the moderate and persistent burden groups exhibited significantly lower capabilities in ADLs, poorer memory, increased social interactions, and lower life satisfaction. The emerging group displayed a similar trend, though without statistically significant results.

Conclusions: Our study suggests that the extent and persistence of musculoskeletal disease burden can significantly affect holistic well-being among middle-aged and older individuals.