title: Back pain in seniors: the Back pain Outcomes using Longitudinal Data (BOLD) cohort baseline data.
abstract: BACKGROUND
  Back pain represents a substantial burden globally, ranking first in a recent assessment among causes of years lived with disability. Though back pain is widely studied among working age adults, there are gaps with respect to basic descriptive epidemiology among seniors, especially in the United States. Our goal was to describe how pain, function and health-related quality of life vary by demographic and geographic factors among seniors presenting to primary care providers with new episodes of care for back pain.
  
  
  METHODS
  We examined baseline data from the Back pain Outcomes using Longitudinal Data (BOLD) registry, the largest inception cohort to date of seniors presenting to a primary care provider for back pain. The sample included 5,239 patients ≥ 65 years old with a new primary care visit for back pain at three integrated health systems (Northern California Kaiser-Permanente, Henry Ford Health System [Detroit], and Harvard Vanguard Medical Associates [Boston]). We examined differences in patient characteristics across healthcare sites and associations of patient sociodemographic and clinical characteristics with baseline patient-reported measures of pain, function, and health-related quality of life.
  
  
  RESULTS
  Patients differed across sites in demographic and other characteristics. The Detroit site had more African-American patients (50%) compared with the other sites (7-8%). The Boston site had more college graduates (68%) compared with Detroit (20%). Female sex, lower educational status, African-American race, and older age were associated with worse functional disability as measured by the Roland-Morris Disability Questionnaire. Except for age, these factors were also associated with worse pain.
  
  
  CONCLUSIONS
  Baseline pain and functional impairment varied substantially with a number of factors in the BOLD cohort. Healthcare site was an important factor. After controlling for healthcare site, lower education, female sex, African-American race, and older age were associated with worse physical disability and all of these factors except age were associated with worse pain.
  
  
  BACKGROUND
  Clinical Trials.gov NCT01776242; Registration date: June 13, 2012.
authors.affiliation: Department of Radiology, University of Washington, 325 Ninth Ave,, Box 359728, Seattle, WA 98104-2499, USA. jarvikj@uw.edu.
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Jarvik
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Comstock
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Heagerty
authors.forename: Judith A
authors.initials: JA
authors.lastname: Turner
authors.forename: Sean D
authors.initials: SD
authors.lastname: Sullivan
authors.forename: Xu
authors.initials: X
authors.lastname: Shi
authors.forename: David R
authors.initials: DR
authors.lastname: Nerenz
authors.forename: Srdjan S
authors.initials: SS
authors.lastname: Nedeljkovic
authors.forename: Larry
authors.initials: L
authors.lastname: Kessler
authors.forename: Kathryn
authors.initials: K
authors.lastname: James
authors.forename: Janna L
authors.initials: JL
authors.lastname: Friedly
authors.forename: Brian W
authors.initials: BW
authors.lastname: Bresnahan
authors.forename: Zoya
authors.initials: Z
authors.lastname: Bauer
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Avins
authors.forename: Richard A
authors.initials: RA
authors.lastname: Deyo
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D015331:Cohort Studies; D016208:Databases, Factual / Q000639:trends; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010147:Pain Measurement / Q000379:methods / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012042:Registries; D016896:Treatment Outcome
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