title: The impact of chronic low back pain on older adults: a comparative study of patients and controls.
abstract: Chronic low back pain (CLBP) is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. Many older adults remain quite functional despite CLBP, and because age-related comorbidities often exist independently of pain (e.g., medical illnesses, sleep disturbance, mobility difficulty), the unique impact of CLBP is unknown. We conducted this research to identify the multidimensional factors that distinguish independent community dwelling older adults with CLBP from those that are pain-free. Three hundred twenty cognitively intact participants (162 with moderate pain for 3 months, and 158 pain-free) underwent comprehensive assessment of pain severity, medical comorbidity (illnesses, body mass index, medications), severity of degenerative disc and facet disease, lumbar flexion, psychological constructs (self-efficacy, mood, overall mental health), and self-reported as well as performance-based physical function. Significant differences were ascertained for all 22 measures. Discriminant function analysis revealed that eight measures uniquely maximized the separation between the two groups (self-reported function with the Functional Status Index and the SF-36, performance-based function with repetitive trunk rotation and functional reach, mood with the Geriatric Depression Scale, comorbidity with the Cumulative Illness Rating Scale and BMI, and severity of degenerative disc disease). These results should help to guide investigators that perform studies of CLBP in older adults and practitioners that want an easily adaptable battery for use in clinical settings.
authors.affiliation: Department of Anesthesiology, Pain Evaluation and Treatment Institute and University of Pittsburgh, Pittsburgh, PA, USA Department of Psychiatry, Pain Evaluation and Treatment Institute and University of Pittsburgh, Pittsburgh, PA, USA Department of Biostatistics, Pain Evaluation and Treatment Institute and University of Pittsburgh, Pittsburgh, PA, USA Department of Medicine, Pain Evaluation and Treatment Institute and University of Pittsburgh, Pittsburgh, PA, USA Department of Bioengineering, Pain Evaluation and Treatment Institute and University of Pittsburgh, Pittsburgh, PA, USA Department of Electrical Engineering, Pain Evaluation and Treatment Institute and University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Rudy
authors.forename: Debra K
authors.initials: DK
authors.lastname: Weiner
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Lieber
authors.forename: Jill
authors.initials: J
authors.lastname: Slaboda
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Boston
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000453:epidemiology* / Q000523:psychology*; D017116:Low Back Pain; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence; D011584:Psychology / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D018434:Sickness Impact Profile