title: 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.
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.
  
  
  METHODS
  Cross-sectional survey and examination.
  
  
  METHODS
  Community-based cohort of the Health, Aging, and Body Composition (Health ABC) study.
  
  
  METHODS
  Participants were 2,766 community-dwelling adults, aged 70-79; 42% were African American, 52% were men.
  
  
  METHODS
  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.
authors.affiliation: Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15206, USA. dweiner@pitt.edu
authors.forename: Debra K
authors.initials: DK
authors.lastname: Weiner
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Haggerty
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Kritchevsky
authors.forename: Tamara
authors.initials: T
authors.lastname: Harris
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Simonsick
authors.forename: Michael
authors.initials: M
authors.lastname: Nevitt
authors.forename: Anne
authors.initials: A
authors.lastname: Newman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression; D004185:Disability Evaluation; D005260:Female; D005544:Forecasting; D015577:Geriatric Assessment; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000523:psychology; D008297:Male; D012647:Self-Assessment