How does low back pain impact physical function in independent, well-functioning older adults? Evidence from the health ABC cohort and implications for the future

Debra K. Weiner, Catherine L. Haggerty, Stephen B. Kritchevsky, Tamara Harris, Eleanor Marie Simonsick, Michael Nevitt, Anne Newman

Research output: Contribution to journalArticle

Abstract

Objective. To determine the relationships between low back pain (LBP) frequency and intensity and self-reported and performance-based physical function in a large cohort of well-functioning older adults. Design. Cross-sectional survey and examination. Setting. Community-based cohort of the Health, Aging, and Body Composition (Health ABC) study. Participants. Participants were 2,766 community-dwelling adults, aged 70-79; 42% were African American, 52% were men. Outcome Measures. 1) Back pain - location, frequency, intensity; 2) Hip and/or knee pain; 3) Body mass index (BMI); 4) Self-reported difficulty doing functional tasks; 5) Lower extremity function, using the battery from the Established Populations for Epidemiologic Studies in the Elderly (EPESE); 6) Self-rated health; 7) Comorbidity; 8) Depressive symptoms, using the Center for Epidemiological Studies-Depression (CES-D) scale. Results. LBP was common (36%), and its frequency/intensity was significantly associated with other pain and comorbidities. In gender-specific models, LBP frequency/intensity was not significantly associated with EPESE performance score after adjusting for age, race, BMI, CES-D score, knee pain, hip pain, and other comorbidities. LBP frequency/intensity, however, was significantly associated with self-reported difficulty with most functional tasks after adjusting for important confounders. Conclusions. Among well-functioning community-dwelling older adults, LBP frequency/intensity was associated with perceived difficulty in performing important functional tasks, but not with observed physical performance. The demonstrated dose-response relationship between pain frequency/intensity and self-reported task performance difficulty underscores the importance of clinical efforts to treat pain without necessarily eradicating it. Additional work is needed to determine whether back pain is associated with a risk for progressive functional decline and loss of independence in older adults and whether therapeutic interventions can ameliorate decline and, therefore, preserve independence.

Original languageEnglish (US)
Pages (from-to)311-320
Number of pages10
JournalPain Medicine
Volume4
Issue number4
DOIs
StatePublished - 2003
Externally publishedYes

Fingerprint

Low Back Pain
Pain
Epidemiologic Studies
Health
Independent Living
Comorbidity
Back Pain
Depression
Hip
Knee
Body Mass Index
Task Performance and Analysis
Body Composition
African Americans
Population
Lower Extremity
Cross-Sectional Studies
Outcome Assessment (Health Care)

Keywords

  • Disability
  • Low back pain
  • Older adults
  • Physical function

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

How does low back pain impact physical function in independent, well-functioning older adults? Evidence from the health ABC cohort and implications for the future. / Weiner, Debra K.; Haggerty, Catherine L.; Kritchevsky, Stephen B.; Harris, Tamara; Simonsick, Eleanor Marie; Nevitt, Michael; Newman, Anne.

In: Pain Medicine, Vol. 4, No. 4, 2003, p. 311-320.

Research output: Contribution to journalArticle

Weiner, Debra K. ; Haggerty, Catherine L. ; Kritchevsky, Stephen B. ; Harris, Tamara ; Simonsick, Eleanor Marie ; Nevitt, Michael ; Newman, Anne. / How does low back pain impact physical function in independent, well-functioning older adults? Evidence from the health ABC cohort and implications for the future. In: Pain Medicine. 2003 ; Vol. 4, No. 4. pp. 311-320.
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abstract = "Objective. To determine the relationships between low back pain (LBP) frequency and intensity and self-reported and performance-based physical function in a large cohort of well-functioning older adults. Design. Cross-sectional survey and examination. Setting. Community-based cohort of the Health, Aging, and Body Composition (Health ABC) study. Participants. Participants were 2,766 community-dwelling adults, aged 70-79; 42{\%} were African American, 52{\%} were men. Outcome Measures. 1) Back pain - location, frequency, intensity; 2) Hip and/or knee pain; 3) Body mass index (BMI); 4) Self-reported difficulty doing functional tasks; 5) Lower extremity function, using the battery from the Established Populations for Epidemiologic Studies in the Elderly (EPESE); 6) Self-rated health; 7) Comorbidity; 8) Depressive symptoms, using the Center for Epidemiological Studies-Depression (CES-D) scale. Results. LBP was common (36{\%}), and its frequency/intensity was significantly associated with other pain and comorbidities. In gender-specific models, LBP frequency/intensity was not significantly associated with EPESE performance score after adjusting for age, race, BMI, CES-D score, knee pain, hip pain, and other comorbidities. LBP frequency/intensity, however, was significantly associated with self-reported difficulty with most functional tasks after adjusting for important confounders. Conclusions. Among well-functioning community-dwelling older adults, LBP frequency/intensity was associated with perceived difficulty in performing important functional tasks, but not with observed physical performance. The demonstrated dose-response relationship between pain frequency/intensity and self-reported task performance difficulty underscores the importance of clinical efforts to treat pain without necessarily eradicating it. Additional work is needed to determine whether back pain is associated with a risk for progressive functional decline and loss of independence in older adults and whether therapeutic interventions can ameliorate decline and, therefore, preserve independence.",
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AB - Objective. To determine the relationships between low back pain (LBP) frequency and intensity and self-reported and performance-based physical function in a large cohort of well-functioning older adults. Design. Cross-sectional survey and examination. Setting. Community-based cohort of the Health, Aging, and Body Composition (Health ABC) study. Participants. Participants were 2,766 community-dwelling adults, aged 70-79; 42% were African American, 52% were men. Outcome Measures. 1) Back pain - location, frequency, intensity; 2) Hip and/or knee pain; 3) Body mass index (BMI); 4) Self-reported difficulty doing functional tasks; 5) Lower extremity function, using the battery from the Established Populations for Epidemiologic Studies in the Elderly (EPESE); 6) Self-rated health; 7) Comorbidity; 8) Depressive symptoms, using the Center for Epidemiological Studies-Depression (CES-D) scale. Results. LBP was common (36%), and its frequency/intensity was significantly associated with other pain and comorbidities. In gender-specific models, LBP frequency/intensity was not significantly associated with EPESE performance score after adjusting for age, race, BMI, CES-D score, knee pain, hip pain, and other comorbidities. LBP frequency/intensity, however, was significantly associated with self-reported difficulty with most functional tasks after adjusting for important confounders. Conclusions. Among well-functioning community-dwelling older adults, LBP frequency/intensity was associated with perceived difficulty in performing important functional tasks, but not with observed physical performance. The demonstrated dose-response relationship between pain frequency/intensity and self-reported task performance difficulty underscores the importance of clinical efforts to treat pain without necessarily eradicating it. Additional work is needed to determine whether back pain is associated with a risk for progressive functional decline and loss of independence in older adults and whether therapeutic interventions can ameliorate decline and, therefore, preserve independence.

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