Predictors of Persistent Disability and Back Pain in Older Adults with a New Episode of Care for Back Pain.

Abstract

Objective:

To identify predictors of persistent disability and back pain in older adults.

Design:

Prospective cohort study.

Setting:

Back pain outcomes using longitudinal data registry.

Subjects:

Five thousand two hundred twenty adults age 65 years and older with a new primary care visit for back pain.

Methods:

Baseline measurements included: demographics, health, and back pain characteristics. We abstracted imaging findings from 348 radiology reports. The primary outcomes were the Roland-Morris Disability Questionnaire (RMDQ) and back pain intensity. We defined persistent disability as RMDQ of 4/24 or higher at both six and 12 months and persistent back pain as pain 3/10 or higher at both six and 12 months.

Results:

There were 2,498 of 4,143 (60.3%) participants with persistent disability, and 2,099 of 4,144 (50.7%) had persistent back pain. Adjusted analyses showed the following characteristics most strongly predictive of persistent disability and persistent back pain: sex, race, worse baseline clinical characteristics of back pain, leg pain, back-related disability and duration of symptoms, smoking, anxiety symptoms, depressive symptoms, a history of falls, greater number of comorbidities, knee osteoarthritis, wide-spread pain syndromes, and an index diagnosis of lumbar spinal stenosis. Within the imaging data subset, central spinal stenosis was not associated with disability or pain.

Conclusion:

We found that many predictors in older adults were similar to those for younger populations.

• Authors: Sean D Rundell, Karen J Sherman, Patrick J Heagerty, Charles N Mock, Nathan J Dettori, Bryan A Comstock, Andrew L Avins, Srdjan S Nedeljkovic, David R Nerenz, Jeffrey G Jarvik
• Journal: Pain medicine (Malden, Mass.) (Pain Med) Vol. 18 Issue 6 Pg. 1049-1062 (06 01 2017) ISSN: 1526-4637 [Electronic] England
• PMID: 27688311 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S., Research Support, Non-U.S. Gov't)
• Copyright: © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: [email protected]

Topics

• Aged
• Aged, 80 and over
• Back Pain (diagnostic imaging, therapy)
• Cohort Studies
• Disability Evaluation
• Disabled Persons
• Episode of Care
• Female
• Follow-Up Studies
• Humans
• Longitudinal Studies
• Male
• Pain Measurement (methods, trends)
• Predictive Value of Tests
• Prospective Studies