Locomotive syndrome and increased musculoskeletal disorder incidence in older adults: a prospective study

With the population aging, musculoskeletal disorders increasingly impair older adults' quality of life and escalating healthcare costs, necessitating effective prevention strategies. Locomotive syndrome (LS), characterized by mobility decline due to musculoskeletal dysfunction, is closely linked to these disorders. However, its role in predicting future musculoskeletal conditions remains unclear. This study examined the association between LS and the incidence of newly diagnosed musculoskeletal disorders.

This prospective study included 367 community-dwelling adults aged ≥ 40 years who were independent in daily activities. LS was assessed using the five-question Geriatric Locomotive Function Scale (GLFS-5). The primary outcome was the incidence of musculoskeletal disorders, including osteoarthritis, lumbar spinal stenosis, and osteoporosis. Cox proportional hazards regression analyzed associations between LS and future diagnoses, while receiver operating characteristic (ROC) analysis determined the GLFS-5 cutoff score for risk prediction.

At baseline, 19.1% of participants had LS. Over four years, musculoskeletal disorders occurred more frequently in participants with LS than in those without (22.2 vs. 8.8 per 100 person-years, p < 0.001). After adjusting for covariates, LS remained a significant risk factor (hazard ratio 1.98, 95% confidence interval 1.16-3.36, p = 0.011). ROC analysis identified a GLFS-5 cutoff score of 2 (sensitivity: 62.0%, specificity: 62.0%).

LS nearly doubled the risk of musculoskeletal disorders, with a GLFS-5 score ≥ 2 serving as an early risk indicator. Proactive screening and targeted interventions may mitigate this risk in aging populations.