title: Risk Factors and Disability Associated with Low Back Pain in Older Adults in Low- and Middle-Income Countries. Results from the WHO Study on Global AGEing and Adult Health (SAGE).
abstract: BACKGROUND
  Back pain is a common disabling chronic condition that burdens individuals, families and societies. Epidemiological evidence, mainly from high-income countries, shows positive association between back pain prevalence and older age. There is an urgent need for accurate epidemiological data on back pain in adult populations in low- and middle-income countries (LMICs) where populations are ageing rapidly. The objectives of this study are to: measure the prevalence of back pain; identify risk factors and determinants associated with back pain, and describe association between back pain and disability in adults aged 50 years and older, in six LMICs from different regions of the world. The findings provide insights into country-level differences in self-reported back pain and disability in a group of socially, culturally, economically and geographically diverse LMICs.
  
  
  METHODS
  Standardized national survey data collected from adults (50 years and older) participating in the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) were analysed. The weighted sample (n = 30, 146) comprised respondents in China, Ghana, India, Mexico, South Africa and the Russian Federation. Multivariable regressions describe factors associated with back pain prevalence and intensity, and back pain as a determinant of disability.
  
  
  RESULTS
  Prevalence was highest in the Russian Federation (56%) and lowest in China (22%). In the pooled multi-country analyses, female sex, lower education, lower wealth and multiple chronic morbidities were significant in association with past-month back pain (p<0.01). About 8% of respondents reported that they experienced intense back pain in the previous month.
  
  
  CONCLUSIONS
  Evidence on back pain and its impact on disability is needed in developing countries so that governments can invest in cost-effective education and rehabilitation to reduce the growing social and economic burden imposed by this disabling condition.
authors.affiliation: Department Public Health and Clinical Medicine Epidemiology and Global Health, Umeå University, Umeå, Sweden; Research Centre for Gender, Health and Ageing, Faculty of Health, University of Newcastle, Newcastle, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Stewart Williams
authors.affiliation: Department Public Health and Clinical Medicine Epidemiology and Global Health, Umeå University, Umeå, Sweden.
authors.forename: Nawi
authors.initials: N
authors.lastname: Ng
authors.affiliation: Human Sciences Research Council, Pretoria, South Africa; Department of Psychology, University of the Free State, Bloemfontein, South Africa; ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand.
authors.forename: Karl
authors.initials: K
authors.lastname: Peltzer
authors.affiliation: Department of Community Health, University of Ghana, Accra, Ghana.
authors.forename: Alfred
authors.initials: A
authors.lastname: Yawson
authors.affiliation: Department of Community Health, University of Ghana, Accra, Ghana.
authors.forename: Richard
authors.initials: R
authors.lastname: Biritwum
authors.affiliation: National Research Institute of Public Health (FSBI, RAMS), Moscow, Russian Federation.
authors.forename: Tamara
authors.initials: T
authors.lastname: Maximova
authors.affiliation: Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Wu
authors.affiliation: International Institute of Population Sciences, Deonar, Mumbai, India.
authors.forename: Perianayagam
authors.initials: P
authors.lastname: Arokiasamy
authors.affiliation: Research Centre for Gender, Health and Ageing, Faculty of Health, University of Newcastle, Newcastle, Australia; World Health Organization Study on global AGEing and adult health, Geneva, Switzerland.
authors.forename: Paul
authors.initials: P
authors.lastname: Kowal
authors.affiliation: World Health Organization Study on global AGEing and adult health, Geneva, Switzerland; Surveys, Measurement and Analysis Unit, World Health Organization, Geneva, Switzerland.
authors.forename: Somnath
authors.initials: S
authors.lastname: Chatterji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D003710:Demography; D003906:Developing Countries / Q000191:economics* / Q000706:statistics & numerical data*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007182:Income; D016015:Logistic Models; D017116:Low Back Pain / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011634:Public Health; D012307:Risk Factors; D014944:World Health Organization