Association of Back Pain with All-Cause and Cause-Specific Mortality Among Older Women: a Cohort Study.
J Gen Intern Med
; 34(1): 90-97, 2019 01.
Article
em En
| MEDLINE
| ID: mdl-30350028
ABSTRACT
BACKGROUND:
The impact of back pain on disability in older women is well-understood, but the influence of back pain on mortality is unclear.OBJECTIVE:
To examine whether back pain was associated with all-cause and cause-specific mortality in older women and mediation of this association by disability.DESIGN:
Prospective cohort study.SETTING:
The Study of Osteoporotic Fractures.PARTICIPANTS:
Women aged 65 or older. MEASUREMENT Our primary outcome, time to death, was assessed using all-cause and cause-specific adjusted Cox models. We used a four-category back pain exposure (no back pain, non-persistent, infrequent persistent, or frequent persistent back pain) that combined back pain frequency and persistence across baseline (1986-1988) and first follow-up (1989-1990) interviews. Disability measures (limitations of instrumental activities of daily living [IADL], slow chair stand time, and slow walking speed) from 1991 were considered a priori potential mediators.RESULTS:
Of 8321 women (mean age 71.5, SD = 5.1), 4975 (56%) died over a median follow-up of 14.1 years. A higher proportion of women with frequent persistent back pain died (65.8%) than those with no back pain (53.5%). In the fully adjusted model, women with frequent persistent back pain had higher hazard of all-cause (hazard ratio [HR] = 1.24 [95% CI, 1.11-1.39]), cardiovascular (HR = 1.34 [CI, 1.12-1.62]), and cancer (HR = 1.33, [CI 1.03-1.71]) mortality. No association with mortality was observed for other back pain categories. In mediation analyses, IADL limitations explained 47% of the effect of persistent frequent back pain on all-cause mortality, slow chair stand time, and walking speed, explained 27% and 24% (all significant, p < 0.001), respectively.LIMITATIONS:
Only white women were included.CONCLUSION:
Frequent persistent back pain was associated with increased mortality in older women. Much of this association was mediated by disability.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pessoas com Deficiência
/
Dor nas Costas
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Avaliação da Deficiência
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Fraturas por Osteoporose
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
/
Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article