[Shoulder function and scores in 180 asymptomatic individuals aged over 75 years]

The purpose of this study was to define the normal shoulder in patients aged over 75 years and to look for correlations between general health, mental status and shoulder function.

Shoulder motion, rotator cuff strength and abnormal movements were evaluated in 180 subjects over 75 without surgical history involving the shoulder. Body mass index (BMI) was determined for each subject. The Simple Shoulder Test (SST) was performed and the Constant and Murley score was calculated for each shoulder. The Beck test was used to assess depression. When joint function was impaired, supplementary x-ray and ultrasound examinations were performed.

Asymptomatic pathological features (rotator cuff tears, stiffness, degenerative joint disease) were identified in 56% of the shoulders. Only 44% of the shoulders were free of pathological features. 56.4% of rotator cuff tears were found in the dominant shoulder; 13.9% of subjects had bilateral degenerative joint disease; 23.3% had bilateral stiffness. There were many associated conditions: cardiovascular (33%), pulmonary (28%), gastrointestinal (25.6%), diabetes (12.2%), tumors (10.6%). 18.3% of the subjects were depressive and 14.4% were taking treatment for depression. Shoulder motion and strength were correlated with BMI and nutritional status. Thin subjects (BMI < 20) had more rotator cuff tears. Obese subjects (BMI > 29.9) had more degenerative joint disease and joint stiffness. Demand for treatment and examinations were greater among depressed subjects.

Shoulder function is compatible with normal lifestyle in subjects over 75, corresponding to their desires and expectations. Shoulder function is correlated with body mass index and mental status. We should carefully assess shoulders in elderly subjects because good shoulder function, even if impaired, is often compatible with moderate stiffness, mild osteoarthritis, and rotator cuff tears, with no particular need for surgery.