Restricting Back Pain and Subsequent Disability in Activities of Daily Living Among Community-Living Older Adults

Objective: To evaluate the relationship between back pain severe enough to restrict activity (restricting back pain) and subsequent disability in essential (e) and instrumental (i) activities of daily living (ADL) among community-living older adults. Method: In this prospective cohort study, we evaluated 754 adults, aged 70 years who were initially nondisabled in eADL. Restricting back pain and disability were assessed during monthly interviews for up to 159 months. Associations between restricting back pain and subsequent eADL and iADL disability were evaluated using recurrent events Cox models, adjusted for fixed-in-time and time-varying covariates. Results: Strong associations were found between restricting back pain and eADL and iADL disability, with hazard ratios (95% confidence intervals) of 3.47 [3.01, 3.90] and 2.33 [2.08, 2.61], respectively. Discussion: Restricting back pain was independently associated with subsequent disability in eADL and iADL. Interventions focused on decreasing restricting back pain in older adults may have the potential to reduce the subsequent burden of disability.