title: Back Complaints in the Elders in Brazil and the Netherlands: a cross-sectional comparison.
abstract: although back pain is most prevalent in older adults, there is a paucity of studies investigating back pain in older people. Our objective was to characterize and compare Brazilian and Dutch older adults presenting to primary care with a new episode of back pain. We also aimed to investigate whether socio-demographic characteristics were associated with pain severity and disability.
  
  
  
  we sourced data on 602 Brazilian and 675 Dutch participants aged ≥55 years with a new episode of back pain from the Back Complaints in the Elders consortium. We analyzed country differences in participants' characteristics, and associations between socio-demographic/clinical characteristics and pain severity and pain-related disability.
  
  
  
  the two populations differed in most characteristics. More Dutch participants were smokers, heavy drinkers, and reported back stiffness. More Brazilian participants were less educated, had higher prevalence of comorbidities; higher levels of pain intensity, disability and psychological distress. When controlling for the effect of country, being female and having altered quality of sleep were associated with higher pain intensity. Altered quality of sleep, having two or more comorbidities and physical inactivity were associated with higher disability. Higher educational levels were negatively associated with both pain and disability outcomes.
  
  
  
  back pain is disabling in the older population. Our country comparison has shown that country of residence is an important determinant of higher disability and pain in older people with back pain. Irrespective of country, women with poor sleep quality, comorbidities, low education and who are physically inactive report more severe symptoms.
authors.affiliation: Department of Physical Therapy, Faculty of Medicine, Universidade Federal do Ceará, Fortaleza, Brazil.|Post Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, School of Physical Education, Physiotherapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Fabianna R
authors.initials: FR
authors.lastname: Jesus-Moraleida
authors.affiliation: Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Paulo H
authors.initials: PH
authors.lastname: Ferreira
authors.affiliation: The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Manuela L
authors.initials: ML
authors.lastname: Ferreira
authors.affiliation: Post Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, School of Physical Education, Physiotherapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Juscelio P
authors.initials: JP
authors.lastname: Silva
authors.affiliation: The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Maher
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Wendy T M
authors.initials: WTM
authors.lastname: Enthoven
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Orthopaedics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Sita M A
authors.initials: SMA
authors.lastname: Bierma-Zeinstra
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Pim A J
authors.initials: PAJ
authors.lastname: Luijsterburg
authors.affiliation: Post Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, School of Physical Education, Physiotherapy, and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Leani S M
authors.initials: LSM
authors.lastname: Pereira
mesh_terms: D000367:Age Factors; D000375:Aging; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D001416:Back Pain / Q000175:diagnosis / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D059408:Pain Management; D011320:Primary Health Care; D011446:Prospective Studies; D012307:Risk Factors; D057185:Sedentary Behavior; D012720:Severity of Illness Index; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology
keywords: aged; back pain; epidemiology; older people; pain