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Musculoskeletal Epidemiology

Musculoskeletal disorders are among the most common causes of activity limitation and disability among persons age 65 and above. More than 340,000 persons in this age group fracture a hip each year in the US; between 18% and 30% of them die and more than half of survivors do not return to pre-fracture levels of walking within a year.

A large body of collaborative research has been undertaken by researchers in various departments in the School of Medicine (Epidemiology and Public Health, Orthopaedic Surgery, Radiology, Physical Therapy and Rehabilitation Science, and Medicine), in the Schools of Social Work, Nursing, and Pharmacy, and in Baltimore community hospitals. This research has addressed numerous topics including the following:

  • Identification of factors which lead to hip fractures
  • Testing of interventions to reduce the risk of fractures
  • The functional, physiologic, and cellular sequelae of hip fracture
  • Identification of medical and social factors that can enhance recovery from hip fracture
  • Evaluation of interventions to optimize functional, physiologic, and cellular recovery following hip fracture
  • Identification of risk factors for pressure ulcers in hip fracture patients so that appropriate preventive interventions can be developed and evaluated

While a major emphasis of musculoskeletal research in the Epidemiology of Aging Training Program has been on hip fracture, other musculoskeletal conditions that result in disability for older persons are also emphasized. These include osteoarthritis and rheumatoid arthritis, osteoporosis, and total hip and total knee replacement.

Representative Publications

The hormonal profile of hip fracture female patients differs from community-dwelling peers over a 1-year follow-up period. Cappola AR, Hawkes WG, Blocher N, Yu-Yahiro J, Orwig D, Fredman L, Miller RR, Guralnik JM, Magaziner J. Osteoporos Int. 2010 Mar 4. [Epub ahead of print] PMID: 20204599 

Design and implementation of a home-based exercise program post-hip fracture: the Baltimore hip studies experience. Yu-Yahiro JA, Resnick B, Orwig D, Hicks G, Magaziner J. PM R. 2009 Apr;1(4):308-18. PMID: 19627913

Use of pressure-redistributing support surfaces among elderly hip fracture patients across the continuum of care: adherence to pressure ulcer prevention guidelines. Baumgarten M, Margolis D, Orwig D, Hawkes W, Rich S, Langenberg P, Shardell M, Palmer MH, McArdle P, Sterling R, Jones PS, Magaziner J. Gerontologist. 2010 Apr;50(2):253-62. Epub 2009 Jul 8. PMID: 19587108

Structure-modifying effects of chondroitin sulfate in knee osteoarthritis: an updated meta-analysis of randomized placebo-controlled trials of 2-year duration. Hochberg MC. Osteoarthritis Cartilage. 2010 Apr 26. [Epub ahead of print] PMID: 20399895

Repeat falls and the recovery of social participation in the year post-hip fracture. Miller RR, Ballew SH, Shardell MD, Hicks GE, Hawkes WG, Resnick B, Magaziner J. Age Ageing. 2009 Sep;38(5):570-5. Epub 2009 Jul 8. PMID: 19586976

Women with hip fracture experience greater loss of geometric strength in the contralateral hip during the year following fracture than age-matched controls. Reider L, Beck TJ, Hochberg MC, Hawkes WG, Orwig D, YuYahiro JA, Hebel JR, Magaziner J; Study of Osteoporotic Fractures Research Group. Osteoporos Int. 2010 May;21(5):741-50. Epub 2009 Jul 2. PMID: 19572093

Social support for exercise by experts in older women post-hip fracture. Casado BL, Resnick B, Zimmerman S, Nahm ES, Orwig D, Macmillan K, Magaziner J. J Women Aging. 2009;21(1):48-62. PMID: 19199153

Association between interleukin-6 and lower extremity function after hip fracture--the role of muscle mass and strength. Miller RR, Shardell MD, Hicks GE, Cappola AR, Hawkes WG, Yu-Yahiro JA, Magaziner J. J Am Geriatr Soc. 2008 Jun;56(6):1050-6. Epub 2008 Apr 11. PMID: 18410321

Caregiving intensity and change in physical functioning over a 2-year period: results of the caregiver-study of osteoporotic fractures. Fredman L, Doros G, Ensrud KE, Hochberg MC, Cauley JA. Am J Epidemiol. 2009 Jul 15;170(2):203-10. Epub 2009 May 14. PMID: 19443666