Effect of Arthritis in Middle Age on Older-Age Functioning

in middle age predicts the earlier onset of functional diffi-culties (difficulty with activities of daily living (ADLs) and walking) that are associated with loss of independence in older persons. DESIGN: Prospective longitudinal study. SETTING: The Health and Retirement Study, a nationally representative sample of persons aged 50 to 62 at baseline who were followed for 10 years. PARTICIPANTS: Seven thousand five hundred forty-three subjects with no difficulty in mobility or ADL function at baseline. MEASUREMENTS: Arthritis was measured at baseline according to self-report. The primary outcome was time to persistent difficulty in one of five ADLs or mobility (walk-ing several blocks or up a flight of stairs). Difficulty with ADLs or mobility was assessed according to subject inter-view every 2 years. Analyses were adjusted for other co-morbid conditions, body mass index, exercise, and demographic characteristics. RESULTS: Twenty-nine percent of subjects reported ar-thritis at baseline. Subjects with arthritis were more likely to develop persistent difficulty in mobility or ADL function over 10 years of follow-up (34 % vs 18%, adjusted hazard ratio (HR)51.63, 95 % confidence interval (CI)51.43– 1.86). When each component of the primary outcome was assessed separately, arthritis was also associated with per-sistent difficulty in mobility (30 % vs 16%, adjusted HR51.55, 95 % CI51.41–1.71) and persistent difficulty in ADL function (13 % vs 5%, adjusted HR51.85, 95% CI51.58–2.16). CONCLUSION: Middle-aged persons who report a histo-ry of arthritis are more likely to develop mobility and ADL difficulties as they enter old age. This finding highlights the need to develop interventions and treatments that take a life-course approach to preventing the disabling effect o