Abstract
BackgroundMusculoskeletal diseases are characterized by a high degree of comorbidity with common mental disorders and are a major cause of health-related exclusion from working life. Using a prospective design we aimed to examine the relative importance of physical and mental health-related quality of life as predictors of disability pension due to musculoskeletal diseases.MethodsA subsample (N = 18581) born 1953–1957, participated in the The Hordaland Health Study (HUSK) during 1997–1999, and was followed through December 31st 2004. Baseline measures of health-related quality of life were estimated using the Physical (PCS) and Mental Component Summary (MCS) of the Short Form-12 (SF-12). Further information on education, occupation, smoking, physical activity, number of musculoskeletal pain sites and BMI were provided by questionnaires and health examination. The association between self-perceived physical and mental health and subsequent disability pension, obtained from the national database of health and social benefits was estimated using Cox regression analyses.ResultsParticipants reporting poor physical health (quartile 1) had a marked increased risk for disability pension due to musculoskeletal diseases (age and gender-adjusted hazard ratio = 22.1, 95% CI = 12.5–39.0) compared with those reporting good/somewhat good physical health (quartiles 4 and 3 combined). Adjustment for socioeconomic status and lifestyle factors slightly attenuated the association (hazard ratio = 16.7), and adding number of reported pain sites weakened the association even more (hazard ratio = 7.1, 95% CI = 3.8–12.8). Also, participants reporting poor mental health had a higher risk for disability pension due to musculoskeletal diseases (age and gender adjusted hazard ratio = 1.8, 95% CI = 1.3–2.6); however, in the final model the risk was not statistically significant.ConclusionsThe physical component in health-related quality of life (SF-12) was a strong predictor of disability pension due to musculoskeletal diseases, whereas the mental component played a less prominent role.
Highlights
Musculoskeletal diseases are characterized by a high degree of comorbidity with common mental disorders and are a major cause of health-related exclusion from working life
Health-related quality of life (HRQOL) measures the individual’s perception of current health status and its impact on essential spheres in life, such as ability to carry out ordinary work and domestic tasks
HRQOL can be divided into self-perceived physical health and self-perceived mental health [6]
Summary
Musculoskeletal diseases are characterized by a high degree of comorbidity with common mental disorders and are a major cause of health-related exclusion from working life. Using a prospective design we aimed to examine the relative importance of physical and mental health-related quality of life as predictors of disability pension due to musculoskeletal diseases. Musculoskeletal diseases have substantial impact on individuals’ quality of life and are a common cause of sickness absence and disability pension in countries with universal welfare schemes [1]. A population-based study found that self-perceived physical health was strongly associated with subsequent sickness absence, whereas the impact of self-perceived mental health was substantially weaker [9]. There is a lack of studies examining the predictive ability of self-perceived physical and mental health (HRQOL) on disability pension
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