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)

Abstract

Objectives To examine the longitudinal association between baseline disability due to low back pain (LBP) and future risk of falls, particularly significant falls requiring treatment, in a community-dwelling older population. Methods This was a prospective population-based cohort study using data from the Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS; 2008–2010). A total of 2,738 residents aged ≥60 years were enrolled. LBP was assessed using the Roland-Morris Disability Questionnaire (RMDQ), and the level of LBP-related disability was divided into three categories (none, low, and medium to high). Incidence of falls over the following year was determined using a self-reported questionnaire after the one-year follow-up period. The risk ratio (RR) for LBP-related disability associated with any fall and any fall requiring treatment was estimated using log binomial regression models. Results Data were analyzed for 1,358 subjects. The prevalence of LBP at baseline was 16.4%, whereas 122 (8.9%) participants reported a low level of LBP-related disability and 101 (7.4%) reported medium to high levels of LBP-related disability. Incidence of any fall and falls requiring treatment was reported by 22.1% and 4.6% of participants, respectively. Subjects with medium to high levels of disability were more likely to experience subsequent falls (adjusted RR = 1.53, 95% confidence interval [CI] = 1.21–1.95) and falls requiring treatment (adjusted RR = 2.55, 95% CI = 1.41–4.60) than those with no LBP-related disability. Conclusions Level of LBP-related disability was associated with an increased risk of serious falls in a general population of community-living older adults. These findings can alert health care providers involved in fall prevention efforts to the important issue of activity-related disability due to LBP.

Association of low back pain with muscle weakness, decreased mobility function, and malnutrition in older women: A cross-sectional study

“…Previous studies have reported that chronic LBP was associated with decreased mobility function in older populations [29,38]. The results of the current study showed that severe LS was associated with LBP among older women who were scheduled to undergo surgery because of degenerative lower extremity diseases.…”

Assessment of locomotive syndrome among older individuals: a confirmatory factor analysis of the 25-question Geriatric Locomotive Function Scale

“…Although our results did not theoretically discriminate among the 3 factors completely without cross-loading and residual correlations, it would potentially be able to assist clinical physicians in understanding the concept of LS (pain, movement-related difficulty and psycho-social complication) because these factors fundamentally contribute to the concept of LS and are closely linked with each other. Moreover, previous studies also reported relationships between musculoskeletal pain (Hirano et al, 2014;Iizuka et al, 2015;Imagama et al, 2017;Kimachi et al, 2019), movement-related difficulty or functional decline (Akai et al, 2016;Iwaya et al, 2017;Izawa et al, 2019;Muramoto et al, 2012;Yoshimura et al, 2011), and psycho-social complication (Ikemoto et al, 2016;Nakamura et al, 2017aNakamura et al, , 2017bMaruya et al, 2018) and LS. Thus, it seems reasonable to discriminate among these 3 dimensions when assessing LS during clinical practice.…”

Severity Levels of Disability Among Older Adults in Low- and Middle-Income Countries: Results From the Study on Global Ageing and Adult Health (SAGE)

“…Some studies have estimated the severity levels of disability using WHODAS 2.0 (either 12-or 36-item version), following two general approaches. First, using the ICF-recommended classification, a population is classified as: no disability [0-4], mild disability [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24], moderate disability , severe disability , and extreme disability [96-100]. Second, using some multivariate statistical method, individuals are classified according to the association pattern observed among the items of WHODAS 2.0.…”

“…Burden imposed by disability in old age is one of the major challenges faced by healthcare systems worldwide not only in high-income countries (HICs) but also in low-and middle-income countries (LMICs) (3). Disability can occur simultaneously with some geriatric syndromes (falls, frailty, cognitive impairment) (4,5) and chronic conditions (hypertension, myocardial infarction, arthritis, diabetes, stroke) (6,7) and is a major risk factor for adverse outcomes such as falls (8), hospitalizations (9), and mortality (10).…”