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Epidemiology of Restricting Back Pain in Community-Living Older Persons

Authors

  • Una E. Makris MD,

    1. From the *Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut; and Department of Veterans Affairs, West Haven, Connecticut.
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  • Liana Fraenkel MD, MPH,

    1. From the *Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut; and Department of Veterans Affairs, West Haven, Connecticut.
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  • , Ling Han MD, PhD,

    1. From the *Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut; and Department of Veterans Affairs, West Haven, Connecticut.
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  • Linda Leo-Summers MPH,

    1. From the *Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut; and Department of Veterans Affairs, West Haven, Connecticut.
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  • Thomas M. Gill MD

    1. From the *Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut; and Department of Veterans Affairs, West Haven, Connecticut.
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  • These data were presented at the American College of Rheumatology National Meeting, Philadelphia, Pennsylvania, October 19, 2009;
    American Geriatrics Society Annual Meeting, Chicago, Illinois, May 1, 2009;
    National Institute on Aging Technical Assistance Workshop, National Harbor, Maryland, November 20, 2008.

Address correspondence to Dr. Una Makris, Yale University School of Medicine, Section of Rheumatology, PO Box 208031, 300 Cedar Street, S-525 TAC, New Haven, CT 06520. E-mail: una.makris@yale.edu

Abstract

OBJECTIVES: To estimate the incidence of back pain leading to restricted activity (restricting back pain) in community-living older persons and to characterize its descriptive epidemiology.

DESIGN: Prospective cohort study.

SETTING: Greater New Haven, Connecticut.

PARTICIPANTS: Five hundred fifty nondisabled, community-living men and women aged 70 and older who did not report restricting back pain at baseline.

MEASUREMENTS: Participants were interviewed monthly for over 10 years to ascertain the cumulative incidence, time to first episode, incidence rates (first and repeat episodes), and duration of restricting back pain. Cumulative incidence (proportions) was estimated using the Kaplan-Meier method, and incidence rates (per 1,000 person-months) were estimated using a Poisson regression model.

RESULTS: During the more than 10 years of follow-up (median 107 months), the cumulative incidence of restricting back pain was 77.3% for men and 81.7% for women. The median time to the first episode was significantly shorter in women (25 months) than men (49 months) (P=.01). The incidence rates of restricting back pain per 1,000 person-months were 32.9 overall—24.4 for men and 37.5 for women (P<.001). There were no differences according to baseline age group. Of the 1,528 total episodes of restricting back pain, the median duration was 1.0 month, and only 6.4% lasted for 3 or more consecutive months.

CONCLUSION: Restricting back pain in older persons is common, short-lived, and frequently episodic. The burden of restricting back pain is greater in older women than older men.

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