# Musculoskeletal Disorders in Elderly Patients With Diabetes Mellitus in a Rural Community of Bangladesh

## TL;DR

This study finds that elderly people with diabetes in rural Bangladesh commonly suffer from musculoskeletal pain, especially in the lower back and knees, with obesity and poor diabetes control being key risk factors.

## Contribution

The study provides new data on the prevalence and predictors of musculoskeletal disorders among elderly diabetics in rural Bangladesh.

## Key findings

- 76.5% of elderly diabetic participants reported musculoskeletal pain, with women being more affected.
- Lower back, knee, and foot were the most common pain sites, and obesity and uncontrolled diabetes were significant predictors.
- Over half of the participants showed moderate to severe disability due to musculoskeletal disorders.

## Abstract

Background

Among the elderly population of Bangladesh, diabetes mellitus (DM) is highly prevalent. DM has a strong relationship with musculoskeletal (MSK) disorders responsible for chronic pain, disability, and morbidity. Nevertheless, MSK disorder data of elderly diabetics are scarce in the literature, particularly in rural setups. The objective of this study was to evaluate the status of MSK disorders and their associated factors among elderly diabetic people living in rural Bangladesh.

Methods

In this cross-sectional study, we included participants with diabetes over 60 years from six rural villages in Muksudpur Union, Bangladesh. The details of the study, including data collection using the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) questionnaire, followed clinical examination. Disability was assessed using the Health Assessment Questionnaire (HAQ), and associated factors were analyzed statistically.

Results

A total of 234 older adults with diabetes were included from six villages of rural Muksudpur Union, Bangladesh, and were recruited. They were also subjected to clinical examinations after completing the COPCORD questionnaire. Disability was measured by the HAQ and analyzed by stepwise multiple linear regression. A total of 234 persons participated, yielding 179 (76.5%) with MSK pain, of whom 144 (61.5%) were women and 90 (38.5%) men. The lower back (50 (28.6%)), knee (38 (21.7%)), and foot (23 (13.1%)) were the most reported pain sites. MSK disorders were also significantly associated with obesity (BMI ≥ 25 kg/m²) and uncontrolled diabetes. Functional disability was remarkable; 130 (55.5%) of participants were moderately disabled; 71 (30.3%), mildly disabled; and 33 (14.1%), severely disabled.

Conclusion

This study highlighted the high burden of MSK pain among elderly diabetics in rural Bangladesh, with women, obesity, and poor glycemic control as significant predictors. This finding emphasizes the need for early screening and weight control and for integrated healthcare strategies to ameliorate mobility and life quality in this susceptible population.