Level of Low Back Pain-Related Disability Associated With Increased Risk for Serious Falls in Older Adults

woman back pain elderly
woman back pain elderly
In community-dwelling older adults, low back pain-related disability may be associated with an increased risk for serious falls.

In community-dwelling older adults, low back pain (LBP)-related disability may be associated with an increased risk for serious falls, according to a study published in Pain Medicine.

Data from the Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS), which was conducted between 2008 and 2010, were examined for this analysis (n=2738; age, ≥60 years). The Roland-Morris Disability Questionnaire (RMDQ) was used to assess LBP and related disability on a 0- to 24-point scale. Patients were divided into 3 categories, based on the level of LBP-related disability: none, low, and medium to high. The study’s primary outcomes were the incidence of falls over a 1-year period after baseline assessment as well as after the 1-year follow-up.

A total of 1358 individuals from the LOHAS study for whom RMDQ data were available were included. At baseline, the prevalence of LBP was 16.4%. The percentage of patients who reported a low and medium to high level of LBP-related disability were 8.9% and 7.4%, respectively. A small percentage of patients reported falls that required treatment (4.6%), and a larger percentage of patients reported any fall during the follow-up period (22.1%).

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Individuals who reported medium to high levels of disability related to LBP had more subsequent falls compared with individuals without LBP-related disability (adjusted risk ratio, 1.53; 95% CI, 1.21-1.95; P <.001). Participants who reported falls that required treatment had a greater likelihood of experiencing subsequent falls (adjusted risk ratio, 2.55; 95% CI, 1.41-4.60; P =.002).

Limitations of the study include a high number of patients who were lost to follow-up, data missing for 35% patients, and unclear cutoff points for the RMDQ.

“LBP-related disability in older adults may not only reduce quality of life due to pain, it could also simultaneously increase risk [for] falls and, by extension, risk [for] falls requiring treatment,” noted the study authors.

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Kimachi K, Kimachi M, Takegami M, et al. Level of low back pain-related disability is associated with risk of subsequent falls in an older population: locomotive syndrome and health outcomes in Aizu Cohort Study (LOHAS) [published online March 11, 2019]. Pain Med. doi:10.1093/pm/pny313