title: The Prevalence of Neck and Shoulder Symptoms and Associations with Comorbidities and Disability: The Johnston County Osteoarthritis Project.
abstract: OBJECTIVE
  Neck and shoulder pain are common but underreported by older people, raising important questions of frequency, medical comorbidities, gender and racial disparities and functional impact associated with neck and shoulder symptoms in elders, which we examined in this analysis.
  
  
  METHODS
  We performed a cross-sectional analysis in the community-based Johnston County Osteoarthritis Project, a cohort that is representative of the U.S. population, utilizing data from 1672 participants with a mean age of 68 years; 69% were white and 68% were women. Trained staff obtained data on participant-reported: symptoms, comorbidities, depression, and functional status; and performance-based functional assessments. Regression models of neck and shoulder symptoms and functional measures were adjusted for age, sex, race, and body mass index, and additionally for other joint symptoms and comorbidities.
  
  
  RESULTS
  Symptoms of neck (8%), shoulder (13%) or both (13%) were reported by participants. Neck symptoms were most frequently reported by White women; shoulder symptoms were evenly distributed among race and gender subgroups. Neck and shoulder symptoms were associated with cancer, diabetes mellitus, depression, and lung, cardiovascular, and other musculoskeletal problems, as well as pain, aching or stiffness at other sites, and independently with self-reported and performance -based functional measures.
  
  
  CONCLUSIONS
  These findings suggest that primary health care providers should inquire about neck and shoulder symptoms and address potential underlying causes to improve functional status and decrease disability in older people.
authors.affiliation: John A. Burns School of Medicine, Honolulu, HI.
authors.forename: Anne R
authors.initials: AR
authors.lastname: Wright
authors.affiliation: SAS Institute, Cary, NC.
authors.forename: Xiaoyan A
authors.initials: XA
authors.lastname: Shi
authors.affiliation: University of North Carolina, Department of Medicine, Division of Geriatric Medicine, and Center for Aging and Health, Chapel Hill, NC.
authors.forename: Jan
authors.initials: J
authors.lastname: Busby-Whitehead
authors.affiliation: University of North Carolina Department of Medicine, Division of Rheumatology, Allergy, and Immunology, and Thurston Arthritis Research Center, Chapel Hill, NC; University of North Carolina Department of Orthopaedics, Chapel Hill, NC; University of North Carolina Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Jordan
authors.affiliation: University of North Carolina Department of Medicine, Division of Rheumatology, Allergy, and Immunology, and Thurston Arthritis Research Center, Chapel Hill, NC.
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Nelson
keywords: Neck and shoulder symptoms; disability; functional status; musculoskeletal pain