Associations of Multiple Chronic Conditions With Physical Performance and Falls Among Older Adults With Back Pain: A Longitudinal, Population-based Study

Rundell, Sean D.; Karmarkar, Amol; Nash, Michael; Patel, Kushang V.

doi:10.1016/j.apmr.2021.03.025

Cited by 14 publications

(8 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multimorbidity may increase the risk of falls via factors such as pain [ 10 , 11 ], polypharmacy [ 12 , 13 ], disability [ 14 , 15 , 16 ], and sleep problems [ 17 , 18 ]. In the past few years, several studies have investigated the potential association between multimorbidity and falls, and these studies reported a positive multimorbidity–fall relationship [ 19 , 20 , 21 , 22 , 23 , 24 ]. For example, a population-based prospective cohort study of 10,594 middle-aged women from Finland showed that the number of chronic disorders was positively associated with the risk of falls [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although the findings of the previous studies are of particular importance, most of these studies were of cross-sectional nature, and thus, little is known on the directionality of the association between multimorbidity and falls. Moreover, the only two longitudinal studies focusing on the multimorbidity–fall relationship were conducted in specific groups of individuals (i.e., postmenopausal women [ 21 ] and older adults with back pain [ 24 ]), and their results may not be generalizable to the entire older population. Finally, no research has yet studied the potential mediating role of several factors such as pain, polypharmacy, and cognitive impairment in this association.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prospective Association between Multimorbidity and Falls and Its Mediators: Findings from the Irish Longitudinal Study on Ageing

Jacob

Smıth

Kostev

et al. 2022

JCM

View full text Add to dashboard Cite

This study including older adults from Ireland aimed to analyze the prospective association between multimorbidity and falls and to identify the mediators in this relationship. The present study used data from two consecutive waves of the Irish Longitudinal Study on Ageing (TILDA) survey. Multimorbidity was assessed at Wave 1 (2009–2011) and was defined as the presence of at least two chronic conditions. Falls occurring at Wave 2 (2012–2013) were self-reported. Mediating variables considered were polypharmacy, cognitive impairment, sleep problems, pain, low handgrip strength, difficulty in activities of daily living (ADL), obesity, and underweight. Multivariable binary logistic regression and mediation analysis using the Karlson Holm Breen method were conducted. This study included 6900 adults aged ≥50 years (51.6% women; mean [SD] age 63.1 [8.9] years). Compared to no chronic conditions at baseline, there was a positive and significant association between multimorbidity and falls at follow-up, with ORs ranging from 1.32 (95% CI = 1.06–1.64) for 2 conditions to 1.92 (95% CI = 1.54–2.38) for ≥4 conditions. Pain (23.5%), polypharmacy (13.3%), and difficulty in ADL (10.7%) explained the largest proportion of the multimorbidity-fall relationship. Multimorbidity increased risk for incident falls in older adults from Ireland. Interventions should be implemented to reduce fall risk in people with multimorbidity, especially targeting the identified mediators.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prospective Association between Multimorbidity and Falls and Its Mediators: Findings from the Irish Longitudinal Study on Ageing

Jacob

Smıth

Kostev

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…Similarly, alcohol consumption has different cultural implications outside the United States as well. Next, individuals enrolled in the OAI study are predisposed to musculoskeletal disease by design; individuals included in the current study had a higher rate of symptomatic and radiographic knee OA than those in the global population (LBP clusters vs. global population: radiographic OA: 55.8% vs. 28.7%, symptomatic OA: 46.5% vs. 12.4%), 49 though the prevalence of knee OA is typically higher in a population with LBP (50%–70%) 50,51 . A future prospective LBP‐specific cohort studies is warranted to compare social and biological drivers of LBP in a cohort representative of the LBP population.…”

Section: Discussionmentioning

confidence: 95%

“…In addition, findings related to race are likely due to the specific racial demo- 55.8% vs. 28.7%, symptomatic OA: 46.5% vs. 12.4%), 49 though the prevalence of knee OA is typically higher in a population with LBP (50%-70%). 50,51 A future prospective LBP-specific cohort studies is warranted to compare social and biological drivers of LBP in a cohort representative of the LBP population. Such a study should consider other factors like genetics and spine pathologies (e.g., disc degeneration) as well, as these are linked to back pain 52,53 but not covered by the OAI.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic status, mental health, and nutrition are the principal traits for low back pain phenotyping: Data from the osteoarthritis initiative

2023

View full text Add to dashboard Cite

Background: Low back pain (LBP) is a heterogeneous disease with biological, physical, and psychosocial etiologies. Models for predicting LBP severity and chronicity have not made a clinical impact, perhaps due to difficulty deciphering multidimensional phenotypes. In this study, our objective was to develop a computational framework to comprehensively screen metrics related to LBP severity and chronicity and identify the most influential. Methods: We identified individuals from the observational, longitudinal Osteoarthritis Initiative cohort (N = 4796) who reported LBP at enrollment (N = 215). OAI descriptor variables (N = 1190) were used to cluster individuals via unsupervised learning and uncover latent LBP phenotypes. We also developed a dimensionality reduction algorithm to visualize clusters/phenotypes using Uniform Manifold Approximation and Projection (UMAP). Next, to predict chronicity, we identified those with acute LBP (N = 40) and persistent LBP over 8 years of follow-up (N = 66) and built logistic regression and supervised machine learning models.Results: We identified three LBP phenotypes: a "high socioeconomic status, low pain severity group", a "low socioeconomic status, high pain severity group", and an intermediate group. Mental health and nutrition were also key clustering variables, while traditional biomedical factors (e.g., age, sex, BMI) were not. Those who developed chronic LBP were differentiated by higher pain interference and lower alcohol consumption (a correlate to poor physical fitness and lower soceioeconomic status). All models for predicting chronicity had satisfactory performance (accuracy 76%-78%). Conclusions:We developed a computational pipeline capable of screening hundreds of variables and visualizing LBP cohorts. We found that socioeconomic status, mental health, nutrition, and pain interference were more influential in LBP than traditional biomedical descriptors like age, sex, and BMI.

show abstract

“…In addition, 82.9% of their participants who had diabetes had a higher chance of falling than the 17.1% of participants who did not have diabetes. Moreover, Rundell et al [50] reported that older adults with more than one chronic condition had lower physical performance and higher probabilities of repeated falls compared to individuals with no or one chronic condition. These researchers reported that having two, three, or four chronic illnesses was associated with higher odds of recurrent falls than having zero or one chronic condition.…”

Section: Physiological Health Factorsmentioning

confidence: 99%

Exploring factors contributing to the risk of falls in community-dwelling older adults: A review of the literature

Hamato,

Johnson,

Arbabi

et al. 2023

IJH

View full text Add to dashboard Cite

Background: Falling is a big threat to community-dwelling older adults’ independence. The chance of falling increases as people become older, which increases morbidity and mortality. The outcomes related to falls impact families, communities, and healthcare systems. As a result, the Primary Health Care Corporation (PHCC) seeks to decrease the number of falls for community-dwelling older adults in Qatar.Aims: To explore the risk factors for falls in community-dwelling older adults. To inform the education of PHCC nurses so that they might begin to look at prevention strategies.Method: Cronin et al.’s framework guided this integrative literature review. CINAHL, Academic Search Complete, Embase, and PubMed databases were utilized to search for relevant articles. The search process returned 20 articles that met the inclusion requirements.Results: Various intrinsic and extrinsic factors lead to falls in community-dwelling older adults. The intrinsic factors include socio-demographic factors, physical health factors, physiological factors, sensory factors, psychological factors, and social factors. Environmental factors were the sole extrinsic factor.Conclusion: The findings of this literature review can be used to inform the creation of an educational program to improve home care nurses’ understanding of and attitudes toward the causes of falls in community-dwelling older adults. Through this program, nurses may begin to predict factors that lead to falls and, therefore, find strategies that help to reduce them.

show abstract

Associations of Multiple Chronic Conditions With Physical Performance and Falls Among Older Adults With Back Pain: A Longitudinal, Population-based Study

Cited by 14 publications

References 36 publications

Prospective Association between Multimorbidity and Falls and Its Mediators: Findings from the Irish Longitudinal Study on Ageing

Prospective Association between Multimorbidity and Falls and Its Mediators: Findings from the Irish Longitudinal Study on Ageing

Socioeconomic status, mental health, and nutrition are the principal traits for low back pain phenotyping: Data from the osteoarthritis initiative

Exploring factors contributing to the risk of falls in community-dwelling older adults: A review of the literature

Contact Info

Product

Resources

About