Low back pain is closely associated with frailty but not with sarcopenia: Cross‐sectional study of rural Japanese community‐dwelling older adults

Tsuji, Shotaro; Shinmura, Ken; Nagai, Koutatsu; Wada, Yosuke; Kusunoki, Hiroshi; Tamaki, Kunihiko; Ito, Masako; Sano, Kyoko; Amano, Minoru; Hirabayashi, Yoko; Kishimoto, Hiroyuki; Maruo, Keishi; Iseki, Tomoya; Tachibana, Tetsuya

doi:10.1111/ggi.14100

Cited by 15 publications

(11 citation statements)

References 26 publications

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“…Low back pain (LBP) is a common disease leading to a decline in mobility and to frailty worldwide. 1 , 2 LBP is also the leading cause of activity limitations and work absences, affecting 80% of people at some point during their lives. 3 The economic burden associated with LBP exceeds $90 billion per year in the United States.…”

Section: Introductionmentioning

confidence: 99%

PGE2/EP4 skeleton interoception activity reduces vertebral endplate porosity and spinal pain with low-dose celecoxib

et al. 2021

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Skeletal interoception regulates bone homeostasis through the prostaglandin E2 (PGE2) concentration in bone. Vertebral endplates undergo ossification and become highly porous during intervertebral disc degeneration and aging. We found that the PGE2 concentration was elevated in porous endplates to generate spinal pain. Importantly, treatment with a high-dose cyclooxygenase 2 inhibitor (celecoxib, 80 mg·kg−1 per day) decreased the prostaglandin E2 concentration and attenuated spinal pain in mice with lumbar spine instability. However, this treatment impaired bone formation in porous endplates, and spinal pain recurred after discontinuing the treatment. Interestingly, low-dose celecoxib (20 mg·kg−1 per day, which is equivalent to one-quarter of the clinical maximum dosage) induced a latent inhibition of spinal pain at 3 weeks post-treatment, which persisted even after discontinuing treatment. Furthermore, when the prostaglandin E2 concentration was maintained at the physiological level with low-dose celecoxib, endplate porosity was reduced significantly, which was associated with decreased sensory nerve innervation and spinal pain. These findings suggest that low-dose celecoxib may help to maintain skeletal interoception and decrease vertebral endplate porosity, thereby reducing sensory innervation and spinal pain in mice.

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Section: Introductionmentioning

confidence: 99%

PGE2/EP4 skeleton interoception activity reduces vertebral endplate porosity and spinal pain with low-dose celecoxib

et al. 2021

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“…Additionally, our participants had a lower average ODQ score (27.21 vs. 36.90 points). A study by Tsuji et al [ 16 ] investigated 730 community-dwelling older adults aged 65 years and older reported that individuals with increased ODQ scores were 1.05-times more likely to develop frailty. In addition, older participants were most commonly classified as pre-frail and frail (62.30%), with a minority classified as non-frail (37.70%).…”

Section: Discussionmentioning

confidence: 99%

“…Persistent pain was one of the stressors that caused frailty to occur [ 13 ], and pain is reported to be associated with increased risk and severity of frailty in older adults [ 14 ]. Recent studies have found that frail older adults with chronic pain exhibited greater limitations in ADLs and disability compared with older adults without frailty [ 15 , 16 ]. Therefore, frail older adults with LBP are more likely to develop functional limitations that lead to decreased strength and endurance, resulting in physical activity decline in both mobility and distance.…”

Section: Introductionmentioning

confidence: 99%

“…Older adults with LBP may have been more likely to be affected than other groups by limitations in healthcare access or limitations in daily life activity in this situation [ 22 , 23 , 24 ]. As previously indicated, older adults with LBP may experience negative impacts of functional decline and increased pain on mobility [ 11 , 12 , 13 , 14 , 15 , 16 ], resulting in decreased life-space mobility [ 20 , 21 ]. Therefore, assessment of the impact of LBP, including functional status, pain, and life-space mobility, is important for older adults with LBP.…”

Section: Introductionmentioning

confidence: 99%

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Assessing the Predictive Power of Frailty and Life-Space Mobility on Patient-Reported Outcomes of Disability in Older Adults with Low Back Pain

2023

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Background: Frailty and decreased life-space mobility are known as risk factors to develop physical limitations leading to disability in older adults with low back pain (LBP). This cross sectional study aimed to investigate the prevalence and predictive power of frailty and life-space mobility on patient-reported outcomes of disability in older adults with LBP. Methods: The sample comprised 165 older adults with LBP who visited two tertiary care hospitals between December 2021 and February 2022. The participants responded to structured standard questionnaires. Data were analyzed using descriptive statistics and robust logistic regression. Results: More than two-thirds of participants were classified as non-frail (26.67%) or pre-frail (66.67%). Mobility restrictions and minimal to severe disability were identified. Controlling other variables, frailty (OR = 1.74, 95% CI: 1.14–2.64) and restricted life-space mobility (OR = 0.42, 95% CI: 0.26–0.67) were significantly associated with disability. Integrating frailty with life-space mobility evaluations demonstrated the highest predictive power for disability-related LBP (AUC = 0.89, 95% CI: 0.84–0.93). Conclusion: Frailty and restricted life-space mobility significantly predicted disability in older adults with LBP. Healthcare professionals should recognize the critical importance of integrating patient-reported outcomes with screening for frailty and life-space mobility limitation to optimize care or tract symptom progression.

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“…Therefore, the aforementioned confounding factors7 28 were matched or placed in identical conditional control in the current study. Because the pathogenesis of sarcopenia has not been elucidated completely, studies examining the association of sarcopenia with pain have reported inconsistent results: Shafiee et al 29 indicated that sarcopenia is related to pain, whereas Tsuji et al 30 suggested that low back pain, which is not CPSP, is not associated with sarcopenia.…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia is associated with an increase in long-term use of analgesics after elective surgery under general anesthesia

Sun

Chen

et al. 2023

Reg Anesth Pain Med

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PurposeTo elucidate the association of presurgical sarcopenia and long-term non-opioid analgesic and opioid use after elective surgery under general anesthesia.MethodsWe conducted this population-based propensity score matched to investigate the effects of sarcopenia and long-term non-opioid analgesic and opioid use after elective surgery under general anesthesia between 1 October 2016 and 31 December 2019 from Taiwan’s National Health Insurance Research Database. Sarcopenia is a disease and coded as M62.84 in the International Classification of Diseases, 10th Revision, Clinical Modification. The primary outcome was the combined rate of the long-term use of all non-opioid analgesics or opioids over 3 and 6 months after elective surgery. By performing a logistic regression analysis, we calculated the adjusted ORs (aORs) with 95% CIs to identify the independent predictors for long-term non-opioid analgesic and opioid use after surgery.ResultsIn total, 2860 patients underwent elective surgery. The 3-month non-opioid analgesic and opioid use rates were respectively 49.7% and 1.8% in the sarcopenia group and 37.9% and 0.9% in the non-sarcopenia group; by contrast, 6-month non-opioid analgesic and opioid use rates were respectively 31.6% and 1.2% in the sarcopenia group and 17.2% and 0.3% in the non-sarcopenia group. Moreover, presurgical sarcopenia increased the risk of long-term non-opioid analgesic and opioid use after elective surgery under general anesthesia (aORs for non-opioid analgesic use over 3 and 6 months after surgery: 1.17 (95% CI 1.05 to 2.23) and 1.26 (95% CI 1.04 to 1.45), respectively; aORs for opioid use over 3 and 6 months after surgery: 1.17 (95% CI 1.07 to 2.21) and 1.23 (95% CI 1.10 to 3.64), respectively).ConclusionSarcopenia is associated with higher rates of long-term non-opioid analgesic and opioid use after elective surgery under general anesthesia.SummaryThe aim of this study was to compare the long-term use of non-opioid analgesics and opioids after elective surgery under general anesthesia between patients with and without sarcopenia. Results suggest that patients with sarcopenia are more likely to have increased use of non-opioid analgesics and opioids after surgery. Further research is needed to determine if sarcopenia can be modified prior to surgery and if this impacts the need for long-term pain management with these medications.

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Low back pain is closely associated with frailty but not with sarcopenia: Cross‐sectional study of rural Japanese community‐dwelling older adults

Cited by 15 publications

References 26 publications

PGE2/EP4 skeleton interoception activity reduces vertebral endplate porosity and spinal pain with low-dose celecoxib

PGE2/EP4 skeleton interoception activity reduces vertebral endplate porosity and spinal pain with low-dose celecoxib

Assessing the Predictive Power of Frailty and Life-Space Mobility on Patient-Reported Outcomes of Disability in Older Adults with Low Back Pain

Sarcopenia is associated with an increase in long-term use of analgesics after elective surgery under general anesthesia

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