A prospective look at the link between frailty and shoulder function in asymptomatic elderly individuals
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Introduction: The relationship between shoulder function and overall function in the elderly patients is not well understood. It is hypothesized that there is an increased tolerance of shoulder dysfunction in this population. The purpose of our study was to investigate and better understand the relationship between shoulder function, general musculoskeletal health, and frailty in the elderly patients. Materials and Methods: The dominant shoulders of 75 individuals aged >/=65 years without known dominant shoulder pathology were assessed. Demographic data were collected. Functional evaluation was conducted by administering the Constant, American Shoulder and Elbow Surgeons (ASES), and the Short Musculoskeletal Function Assessment (SMFA) questionnaires. Shoulder range of motion and strength were measured and the Fried frailty phenotype was calculated. Mean age of the patients was 73.6 years. Sixty-seven percent of the patients were female. Mean body mass index was 31.2 kg/m(2). Results: Twenty-eight percent of the patients reported the use of an assistive device for ambulation. As frailty increased among the 3 Fried frailty phenotypes (robust, prefrail, and frail), patients had statistically significant lower mean Constant scores (P < .0001), ASES scores (P < .0001), higher overall SMFA scores (P < .0001), and an increase in the use of assistive device for ambulation. Individuals who reported the use of an assistive device for ambulation had lower Constant and ASES scores (P < .0001 and P = .045, respectively) and higher overall SMFA scores (P < .0001). There was no evidence of correlation between body mass index and any of the other measures. Conclusions: Frailty and the use of an assistive device for ambulation correlate with poor shoulder function in patients who do not register shoulder complaints and have no known shoulder pathology. Level of Evidence: Level IV, Prognostic.
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