The relationship between back pain and mortality in older adults varies with disability and gender: <scp>R</scp>esults from the <scp>C</scp>ambridge <scp>C</scp>ity over‐75s <scp>C</scp>ohort (<scp>CC75C</scp>) study

Docking, Rachael; Fleming, Jane; Brayne, Carol; Zhao, Jun; Macfarlane, Gary J.; Jones, Gareth T

doi:10.1002/ejp.568

Cited by 19 publications

(29 citation statements)

References 19 publications

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“…These findings support our hypothesis that more frequent back pain persisting over 2 years is associated with subsequent mortality, and that this association is in part mediated by disability. Our findings were consistent with prior studies that found that older women with daily 14 or disabling 15 back pain had elevated mortality risk. Our finding that any/unspecified back pain reported at a single visit was not associated with mortality was also consistent with previous studies.…”

Section: Discussionsupporting

confidence: 93%

“…[8][9][10][11][12][13][14][15][16] Two studies separated back pain into multiple phenotypes based on pain frequency or impact on physical function, both found an elevated risk of mortality among older women. 14,15 Other studies dichotomized back pain exposure; of these, two observed a small increase in mortality among older adults but did not provide sex-specific results, 13,16 and five found no association. [8][9][10][11][12] All previous studies measured back pain at a single time point.…”

Section: Introductionmentioning

confidence: 99%

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Association of Back Pain with All-Cause and Cause-Specific Mortality Among Older Women: a Cohort Study

Roseen

LaValley

et al. 2018

J GEN INTERN MED

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BACKGROUND: The impact of back pain on disability in older women is well-understood, but the influence of back pain on mortality is unclear. OBJECTIVE: To examine whether back pain was associated with all-cause and cause-specific mortality in older women and mediation of this association by disability. DESIGN: Prospective cohort study. SETTING: The Study of Osteoporotic Fractures. PARTICIPANTS: Women aged 65 or older. MEASUREMENT: Our primary outcome, time to death, was assessed using all-cause and cause-specific adjusted Cox models. We used a four-category back pain exposure (no back pain, non-persistent, infrequent persistent, or frequent persistent back pain) that combined back pain frequency and persistence across baseline (1986-1988) and first follow-up (1989-1990) interviews. Disability measures (limitations of instrumental activities of daily living [IADL], slow chair stand time, and slow walking speed) from 1991 were considered a priori potential mediators. RESULTS: Of 8321 women (mean age 71.5, SD = 5.1), 4975 (56%) died over a median follow-up of 14.1 years. A higher proportion of women with frequent persistent back pain died (65.8%) than those with no back pain (53.5%). In the fully adjusted model, women with frequent persistent back pain had higher hazard of all-cause (hazard ratio [HR] = 1.24 [95% CI, 1.11-1.39]), cardiovascular (HR = 1.34 [CI, 1.12-1.62]), and cancer (HR = 1.33, [CI 1.03-1.71]) mortality. No association with mortality was observed for other back pain categories. In mediation analyses, IADL limitations explained 47% of the effect of persistent frequent back pain on all-cause mortality, slow chair stand time, and walking speed, explained 27% and 24% (all significant, p < 0.001), respectively. LIMITATIONS: Only white women were included. CONCLUSION: Frequent persistent back pain was associated with increased mortality in older women. Much of this association was mediated by disability.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Association of Back Pain with All-Cause and Cause-Specific Mortality Among Older Women: a Cohort Study

Roseen

LaValley

et al. 2018

J GEN INTERN MED

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“…Our results are in agreement with a recent study (Docking et al., ), which found a borderline significance between disabling back pain and mortality, with a HR: 1.30 (95% CI: 0.99–1.70) after adjusting for health‐related variables in a cohort ( n = 1174) with a mean age of 83 years. In another study of older women (Zhu et al., ), with a mean age of 75 years, the authors found a significant association between ‘daily back pain’ (HR: 1.93, 1.08–3.43) but not for ‘frequent back pain’ (HR: 1.24, 0.68–2.26) and mortality, after adjusting for cardiovascular disease risk factors and physical activity levels.…”

Section: Discussionsupporting

confidence: 93%

“…Although the burden of spinal pain as a musculoskeletal condition is firmly established (Haldeman et al., ), little is known as to whether spinal pain potentially reduces life expectancy. With an ageing population, this is relevant as it is well established that chronic (Torrance et al., ) widespread (McBeth et al., ), musculoskeletal pain (Jordan and Croft, ) and degenerative joint disease such as osteoarthritis (Nüesch et al., ) increase the rate of mortality, yet the relationship between spinal pain and all‐cause mortality is unclear (Heliövaara et al., ; Kåreholt and Brattberg, ; Zhu et al., ; Jordan and Croft, ; Docking et al., ). For instance, older adults aged ≥70 years reporting LBP appeared to be at risk of increased mortality (Zhu et al., ; Docking et al., ), while there was more uncertainty in cohorts that included both young and old adults, with one study showing an impact on longevity due to LBP and NP (Jordan and Croft, ), whereas other studies showed no effect (Heliövaara et al., ; Kåreholt and Brattberg, ).…”

Section: Introductionmentioning

confidence: 99%

Is this back pain killing me? All‐cause and cardiovascular‐specific mortality in older Danish twins with spinal pain

Fernandez

Boyle

Hartvigsen

et al. 2017

European Journal of Pain

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“…Further, it is estimated that the prevalence of dementia will double every 20 years (5), two thirds of people with dementia live in the community and one third in care homes. There is also evidence that the prevalence of pain increases with age, particularly disabling pain or pain sufficient to interfere with day to day living (6,7,8). We can therefore assume that pain is present in many older adults, and those with dementia are unlikely to be the exception.…”

Section: Introductionmentioning

confidence: 99%

Usability Testing of the iPhone App to Improve Pain Assessment for Older Adults with Cognitive Impairment (Prehospital Setting): A Qualitative Study

2017

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ObjectivesPain assessment in older adults with cognitive impairment is often challenging and paramedics are not given sufficient tools/training to assess pain. The development of a mobile app may improve pain assessment and management, in this vulnerable population. We conducted usability testing of a newly developed iPhone pain assessment application with potential users, in this case as a tool for clinical paramedic practice to improve pain assessment of older adults with cognitive impairment. MethodsWe conducted usability testing with paramedic students and a Delphi panel of qualified paramedics.Participants studied the app and paper-based algorithm from which the app was developed. The potential use for the app was discussed. Usability testing focus groups were recorded, transcribed verbatim, and analysed using a thematic approach. Proposed recommendations were disseminated to the Delphi panel who reviewed and confirmed them. ResultsTwenty-four paramedic students from two UK ambulance services participated in the focus groups. Usability of the app and its potential were viewed positively. Recommended changes to the app were grouped into the following areas: Overall opinion of the app for use in paramedic services; incorporating technological into the health care setting; improving knowledge and governance; and alternative uses. Sub-themes were identified and are presented.. DiscussionOur results indicate that the pain assessment app constitutes a potentially useful tool in the pre-hospital setting. By providing access to a tool specifically developed to help identify/assess pain in a user-friendly format, paramedics are likely to have increased knowledge and confidence in assessing pain in patients with dementia.

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The relationship between back pain and mortality in older adults varies with disability and gender: Results from the Cambridge City over‐75s Cohort (CC75C) study

Cited by 19 publications

References 19 publications

Association of Back Pain with All-Cause and Cause-Specific Mortality Among Older Women: a Cohort Study

Association of Back Pain with All-Cause and Cause-Specific Mortality Among Older Women: a Cohort Study

Is this back pain killing me? All‐cause and cardiovascular‐specific mortality in older Danish twins with spinal pain

Usability Testing of the iPhone App to Improve Pain Assessment for Older Adults with Cognitive Impairment (Prehospital Setting): A Qualitative Study

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