European Spine Journal

, Volume 25, Issue 9, pp 2822–2832 | Cite as

Low back pain and health-related quality of life in community-dwelling older adults

  • C. Cedraschi
  • C. Luthy
  • A. F. Allaz
  • F. R. Herrmann
  • C. Ludwig
Original Article

Abstract

Purpose

Investigation of self-reported of low back pain (LBP) over the last month and associated health-related quality of life (HRQoL) in a sample of a community-dwelling population aged ≥65.

Methods

Cross-sectional study including older adults selected randomly from population records. Data were collected within a sample stratified by age and sex. Physical and psychological healths were investigated using a standardized definition of LBP and the EuroQoL-5D for HRQoL. Analyses were first conducted on the entire sample (N = 3042) and subsequently considering the subsample who reported LBP and a paired sample drawn from the pool of LBP-free respondents.

Results

889 (29 %) respondents reported LBP within the past month, present ‘most days’ or ‘every day’ in 52 % and limiting activities in the same proportion. Average pain score was 4.6 (SD 2.2; 0–10 scale). Age was associated with pain frequency and duration, with younger groups more often reporting pain ‘some days’ and ‘dating back <3 months’. Results of regression analyses showed that individuals suffering from LBP had significantly more problems than LBP non-sufferers on all EQ-5D subscales, except self-care: pain/discomfort (OR 5.33; 95 % CI [4.19–6.79]), mobility (OR 2.66; 95 % CI [2.04–3.46]), usual activities (OR 1.92; 95 % CI [1.42–2.60]), anxiety/depression (OR 1.59; 95 % CI [1.23–2.04]) and self-care (OR 1.29; 95 % CI [0.84–1.98]).

Conclusion

LBP appears to be a more permanent condition in the older groups. LBP may be a part of the definition of a subgroup of elderly at risk of becoming frail in relation with higher levels of functional limitations, psychological difficulties and social restrictions, hence globally impaired HRQoL.

Keywords

Low back pain Health-related quality of life Older adults Community dwelling 

References

  1. 1.
    Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R et al (2001) Frailty in older adults. Evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M157. doi:10.1093/gerona/56.3.M146 CrossRefPubMedGoogle Scholar
  2. 2.
    Cavrini G, Broccoli S, Puccini A, Zoli M (2012) EQ-5D as a predictor of mortality and hospitalization in elderly people. Qual Life Res 21:269–280. doi:10.2307/41411722 CrossRefPubMedGoogle Scholar
  3. 3.
    Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D (2006) Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 10:287. doi:10.1016/j.ejpain.2005.06.009 CrossRefPubMedGoogle Scholar
  4. 4.
    Langley PC (2011) The prevalence, correlates and treatment of pain in the European Union. Curr Med Res Opin 27:463–480. doi:10.1185/03007995.2010.542136 CrossRefPubMedGoogle Scholar
  5. 5.
    Dagenais S, Caro J, Haldeman S (2008) A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J 8:8–20CrossRefPubMedGoogle Scholar
  6. 6.
    Murray CJL, Barber RM, Foreman KJ, Ozgoren AA, Abd-Allah F, Abera SF, Aboyans V, Abraham JP et al (2015) Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. Lancet. doi:10.1016/s0140-6736(15)61340-x Google Scholar
  7. 7.
    Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, Williams G, Smith E et al (2014) The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 73:968–974. doi:10.1136/annrheumdis-2013-204428 CrossRefPubMedGoogle Scholar
  8. 8.
    Bressler HB, Keyes WJ, Rochon PA, Badley E (1999) The prevalence of low back pain in the elderly. A systematic review of the literature. Spine 24:1813–1819CrossRefPubMedGoogle Scholar
  9. 9.
    Hartvigsen J, Frederiksen H, Christensen K (2006) Back and neck pain in seniors—prevalence and impact. Eur Spine J 15:802–806. doi:10.1007/s00586-005-0983-6 CrossRefPubMedGoogle Scholar
  10. 10.
    Dionne CE, Dunn KM, Croft PR (2006) Does back pain prevalence really decrease with increasing age? A systematic review. Age Ageing 35:229–234. doi:10.1093/ageing/afj055 CrossRefPubMedGoogle Scholar
  11. 11.
    Cecchi F, Debolini P, Lova RM, Macchi C, Bandinelli S, Bartali B, Lauretani F, Benvenuti E et al (2006) Epidemiology of back pain in a representative cohort of Italian persons 65 years of age and older: the InCHIANTI study. Spine 31:1149–1155. doi:10.1097/01.brs.0000216606.24142.e1 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Di Iorio A, Abate M, Guralnik JM, Bandinelli S, Cecchi F, Cherubini A, Corsonello A, Foschini N et al (2007) From chronic low back pain to disability, a multifactorial mediated pathway: the InCHIANTI Study. Spine 32:E809–E815. doi:10.1097/BRS.0b013e31815cd422 CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Docking RE, Fleming J, Brayne C, Zhao J, Macfarlane GJ, Jones GT (2011) Epidemiology of back pain in older adults: prevalence and risk factors for back pain onset. Rheumatology 50:1645–1653. doi:10.1093/rheumatology/ker175 CrossRefPubMedGoogle Scholar
  14. 14.
    Thomas E, Peat G, Harris L, Wilkie R, Croft PR (2004) The prevalence of pain and pain interference in a general population of older adults: cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP). Pain 110:361–368. doi:10.1016/j.pain.2004.04.017 CrossRefPubMedGoogle Scholar
  15. 15.
    Luthy C, Cedraschi C, Allaz A-F, Herrmann FR, Ludwig C (2015) Health status and quality of life: results from a national survey in a community-dwelling sample of elderly people. Qual Life Res 24:1687–1696. doi:10.1007/s11136-014-0894-2 CrossRefPubMedGoogle Scholar
  16. 16.
    Ludwig C, Cavalli S, Oris M (2014) “Vivre/Leben/Vivere”: an interdisciplinary survey addressing progress and inequalities of aging over the past 30 years in Switzerland. Arch Gerontol Geriatr 59:240–248. doi:10.1016/j.archger.2014.04.004 CrossRefPubMedGoogle Scholar
  17. 17.
    Dionne CE, Dunn KM, Croft PR, Nachemson AL, Buchbinder R, Walker BF, Wyatt M, Cassidy JD et al (2008) A consensus approach toward the standardization of back pain definitions for use in prevalence studies. Spine 33:95–103. doi:10.1097/BRS.0b013e31815e7f94 CrossRefPubMedGoogle Scholar
  18. 18.
    EuroQoL Group (1990) EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 16:199–208CrossRefGoogle Scholar
  19. 19.
    Szende A, Oppe M, Devlin N (2007) EQ-5D value sets: inventory, comparative review and user guide. Springer, DordrechtCrossRefGoogle Scholar
  20. 20.
    Greiner W, Weijnen T, Nieuwenhuizen M, Oppe S, Badia X, Busschbach J, Buxton M, Dolan P et al (2003) A single European currency for EQ-5D health states: results from a six-country study. Eur J Health Econ 4:222–231CrossRefPubMedGoogle Scholar
  21. 21.
    Perneger TV, Combescure C, Courvoisier DS (2010) General population reference values for the French version of the EuroQol EQ-5D Health Utility Instrument. Value Health 13:631–635. doi:10.1111/j.1524-4733.2010.00727.x CrossRefPubMedGoogle Scholar
  22. 22.
    Rozzini R, Frisoni GB, Ferrucci L, Barbisoni P, Sabatini T, Ranieri P, Guralnik JM, Trabucchi M (2002) Geriatric index of comorbidity: validation and comparison with other measures of comorbidity. Age Ageing 31:277–285. doi:10.1093/ageing/31.4.277 CrossRefPubMedGoogle Scholar
  23. 23.
    Faresjö T, Faresjö Å (2010) To match or not to match in epidemiological studies—same outcome but less power. Int J Environ Res Public Health 7:325–332. doi:10.3390/ijerph7010325 CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Sebo P, Herrmann FR, Haller DM (2015) How do GPs in Switzerland perceive their patients’ satisfaction and expectations? An observational study. BMJ Open. doi:10.1136/bmjopen-2014-007085 PubMedPubMedCentralGoogle Scholar
  25. 25.
    Fernández-de-las-Peñas C, Hernández-Barrera V, Alonso-Blanco C, Palacios-Ceña D, Carrasco-Garrido P, Jiménez-Sánchez S, Jiménez-García R (2011) Prevalence of neck and low back pain in community-dwelling adults in Spain: a population-based national study. Spine 36:E213–E219. doi:10.1097/BRS.0b013e3181d952c2 CrossRefPubMedGoogle Scholar
  26. 26.
    Palacios-Ceña D, Alonso-Blanco C, Hernández-Barrera V, Carrasco-Garrido P, Jiménez-García R, Fernández-de-las-Peñas C (2014) Prevalence of neck and low back pain in community-dwelling adults in Spain: an updated population-based national study (2009/10–2011/12). Eur Spine J 24:482–492. doi:10.1007/s00586-014-3567-5 CrossRefPubMedGoogle Scholar
  27. 27.
    Rudy TE, Weiner DK, Lieber SJ, Slaboda J, Boston JR (2007) The impact of chronic low back pain on older adults: a comparative study of patients and controls. Pain 131:293–301CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Scudds RJ, Robertson JM (2000) Pain factors associated with physical disability in a sample of community-dwelling senior citizens. J Gerontol A Biol Sci Med Sci 55:M393–M399. doi:10.1093/gerona/55.7.M393 CrossRefPubMedGoogle Scholar
  29. 29.
    Ghanei I, Rosengren BE, Hasserius R, Nilsson J-Å, Mellström D, Ohlsson C, Ljunggren Ö, Karlsson MK (2013) The prevalence and severity of low back pain and associated symptoms in 3009 old men. Eur Spine J 23:814–820. doi:10.1007/s00586-013-3139-0 CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Hartvigsen J, Christensen K, Frederiksen H (2004) Back and neck pain exhibit many common features in old age: a population-based study of 4486 Danish twins 70–102 years of age. Spine 29:576–580CrossRefPubMedGoogle Scholar
  31. 31.
    Rockwood K, Mitnitski A (2007) Frailty in relation to the accumulation of deficits. J Gerontol A Biol Sci Med Sci 62:722–727CrossRefPubMedGoogle Scholar
  32. 32.
    Stubbs B, Binnekade TT, Soundy A, Schofield P, Huijnen IPJ, Eggermont LHP (2013) Are older adults with chronic musculoskeletal pain less active than older adults without pain? A systematic review and meta-analysis. Pain Med 14:1316–1331. doi:10.1111/pme.12154 CrossRefPubMedGoogle Scholar
  33. 33.
    Stubbs B, West E, Patchay S, Schofield P (2014) Is there a relationship between pain and psychological concerns related to falling in community dwelling older adults? A systematic review. Disabil Rehabil 36:1931–1942. doi:10.3109/09638288.2014.882419 CrossRefPubMedGoogle Scholar
  34. 34.
    Harada K, Shibata A, Oka K, Nakamura Y (2015) Association of muscle-strengthening activity with knee and low back pain, falls, and health-related quality of life among Japanese older adults: a cross-sectional survey. J Aging Phys Act 23:1–8. doi:10.1123/japa.2013-0038 CrossRefPubMedGoogle Scholar
  35. 35.
    Covinsky KE, Lindquist K, Dunlop DD, Yelin E (2009) Pain, functional limitations, and aging. J Am Geriatr Soc 57:1556–1561. doi:10.1111/j.1532-5415.2009.02388.x CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Lowsky DJ, Olshansky SJ, Bhattacharya J, Goldman DP (2014) Heterogeneity in healthy aging. J Gerontol A Biol Sci Med Sci 69:640–649. doi:10.1093/gerona/glt162 CrossRefPubMedGoogle Scholar
  37. 37.
    Chang W-C, Lu F-P, Lan T-Y, Wu S-C (2013) Multidimensional health-transition patterns among a middle-aged and older population. Geriatr Gerontol Int 13:571–579. doi:10.1111/j.1447-0594.2012.00937.x CrossRefPubMedGoogle Scholar
  38. 38.
    Stanaway FF, Blyth FM, Cumming RG, Naganathan V, Handelsman DJ, Waite LM, Sambrook PN, Creasey HM et al (2011) Back pain in older male Italian-born immigrants in Australia: the importance of socioeconomic factors. Eur J Pain 15:70–76. doi:10.1016/j.ejpain.2010.05.009 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • C. Cedraschi
    • 1
    • 2
  • C. Luthy
    • 1
  • A. F. Allaz
    • 1
  • F. R. Herrmann
    • 3
  • C. Ludwig
    • 4
  1. 1.Division of General Medical Rehabilitation (SMIR-BS), Geneva University HospitalsUniversity of GenevaGeneva 14Switzerland
  2. 2.Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University HospitalsUniversity of GenevaGeneva 14Switzerland
  3. 3.Division of Geriatrics, Geneva University HospitalsUniversity of GenevaGeneva 14Switzerland
  4. 4.School of Health - GenevaUniversity of Applied Sciences and Arts Western SwitzerlandGenevaSwitzerland

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