Functional Health

The decline in PCS scores in the middle decades of life was associated with an increase in the frequency of musculoskeletal complaints, particularly the symptoms of spinal stenosis and chronic lumbar pain. A potential
problem of survivor bias occurs in the over-65-year category, because the number of individuals in the group is small. The MCS scores did not deviate from the general population across the age spectrum. According to multivariate analysis, chronic allergies and sinus problems were the most prevalent diagnosis-related disease to affect the MCS scores. Hearing problems were also found to be significant. Nearly two-thirds of this cohort underwent one or more operations. Even after surgical treatment, a significant number of individuals reported the presence of disease-related symptoms. Individuals who reported having undergone surgical procedures generally have lower PCS scores. There were, however, minimal effects to the MCS scores. None of the procedures found to be significantly correlated with either PCS or MCS scores were positively correlated. Because this study is of cross-sectional design and does not compare patients before and after treatment, there are a number of possible interpretations of the surgical data: (1) these operations do not provide adequate restoration of physical function; (2) these procedures are performed too late in the natural history of the disorder to fully ameliorate the physical and mental health limitations; (3) the patients who underwent surgery were antecedently the sickest and most disabled, therefore biasing the postsurgical scores; (4) the patients would have been even worse off if they had not had surgery; and (5) at least in the case of spinal stenosis,
these patients had inadequate decompressions by current standards