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Depressive Symptoms as a Risk Factor for Disabling Back Pain in Community-Dwelling Older Persons

Authors

  • M. Carrington Reid PhD, MD,

    1. From the *Division of Geriatrics and Gerontology, Weill Medical College, Cornell University, New York, New YorkCecil G. Sheps Center for Health Services Research, Program on Aging, Disability and Long-Term Care, University of North Carolina, Chapel Hill, North CarolinaDepartment of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut§VA Connecticut Healthcare System, West Haven, Connecticut.
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  • Christianna S. Williams PhD,

    1. From the *Division of Geriatrics and Gerontology, Weill Medical College, Cornell University, New York, New YorkCecil G. Sheps Center for Health Services Research, Program on Aging, Disability and Long-Term Care, University of North Carolina, Chapel Hill, North CarolinaDepartment of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut§VA Connecticut Healthcare System, West Haven, Connecticut.
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  • John Concato MD, Mph,

    1. From the *Division of Geriatrics and Gerontology, Weill Medical College, Cornell University, New York, New YorkCecil G. Sheps Center for Health Services Research, Program on Aging, Disability and Long-Term Care, University of North Carolina, Chapel Hill, North CarolinaDepartment of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut§VA Connecticut Healthcare System, West Haven, Connecticut.
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  • Mary E. Tinetti MD,

    1. From the *Division of Geriatrics and Gerontology, Weill Medical College, Cornell University, New York, New YorkCecil G. Sheps Center for Health Services Research, Program on Aging, Disability and Long-Term Care, University of North Carolina, Chapel Hill, North CarolinaDepartment of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut§VA Connecticut Healthcare System, West Haven, Connecticut.
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  • Thomas M. Gill MD

    1. From the *Division of Geriatrics and Gerontology, Weill Medical College, Cornell University, New York, New YorkCecil G. Sheps Center for Health Services Research, Program on Aging, Disability and Long-Term Care, University of North Carolina, Chapel Hill, North CarolinaDepartment of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut§VA Connecticut Healthcare System, West Haven, Connecticut.
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  • This study was funded through grants from the Robert Wood Johnson Foundation, the American Federation for Aging Research, the Patrick and Catherine Weldon Donaghue Medical Research Foundation, and the National Institute on Aging (1RO1AG17560). Dr. Reid was supported by an Advanced Career Development Award from the Department of Veterans Affairs Health Services Research and Development Service at the time of this study. Dr. Reid's work is currently supported by a Paul Beeson Physician Faculty Scholar in Aging Research and a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar Award. Dr. Gill is the recipient of a Midcareer Investigator Award in Patient-Oriented Research (K24AG021507) from the National Institute on Aging. During the course of this study, he was also a Paul Beeson Physician Faculty Scholar in Aging Research and Robert Wood Johnson Foundation Generalist Physician Faculty Scholar.

Address correspondence to Dr. M. Carrington Reid, Weill Medical College, Cornell University, Division of Geriatrics and Gerontology, Box 39, 525 East 68th Street, New York, NY, 10021. E-mail: mcr2004@med.cornell.edu

Abstract

Objectives: To determine whether the presence of depressive symptoms is an independent risk factor for disabling back pain in community-dwelling older persons.

Design: Prospective cohort study with a 12-month follow-up period.

Setting: General community.

Participants: Seven hundred forty-four members of a large health plan who were aged 70 and older and independent in bathing, walking, dressing, and transferring at baseline.

Measurements: The presence of depressive symptoms, defined as a score of 16 or greater on the Center for Epidemiologic Studies—Depression Scale, was documented during a comprehensive baseline assessment that also included information regarding participants' demographic, medical, and physical/cognitive status. The occurrence of disabling back pain was ascertained during monthly telephone interviews.

Results: Depressive symptoms were present in 153 (20.6%) participants at baseline. Over the 12-month follow-up period, 186 participants (25.0%) reported disabling back pain during 1 to 2 months and 91 (12.2%) during 3 or more months. After adjustment for potential confounders, the presence of depressive symptoms was independently associated with the occurrence of disabling back pain (adjusted odds ratio (AOR)=2.3 (95% confidence interval (CI)=1.2–4.4) for 1 to 2 months with disabling back pain; AOR=7.8 (95% CI=3.7–16.4) for 3 or more months with disabling back pain).

Conclusion: The presence of depressive symptoms is a strong, independent, and highly prevalent risk factor for the occurrence of disabling back pain in community-dwelling older persons.

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