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

Szczegóły
Abstrakt

Tytuł:: Associations of Multiple Chronic Conditions With Physical Performance and Falls Among Older Adults With Back Pain: A Longitudinal, Population-based Study.
Autorzy:: Rundell SD; Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Department of Health Services, University of Washington, Seattle, WA. Electronic address: .
Karmarkar A; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA; Sheltering Arms Institute, Richmond, VA.
Nash M; Center for Biomedical Statistics, University of Washington, Seattle, WA.
Patel KV; Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA.
Źródło:: Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2021 Sep; Vol. 102 (9), pp. 1708-1716. Date of Electronic Publication: 2021 Apr 24.
Typ publikacji:: Journal Article; Research Support, N.I.H., Extramural
Język:: English
Imprint Name(s):: Original Publication: Philadelphia, PA : W.B. Saunders
MeSH Terms:: Accidental Falls*
Multiple Chronic Conditions*
Physical Functional Performance*
Back Pain/*physiopathology
Aged ; Aged, 80 and over ; Chronic Disease ; Cohort Studies ; Female ; Humans ; Longitudinal Studies ; Male ; Retrospective Studies ; Surveys and Questionnaires ; United States
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Grant Information:: K01 HD086290 United States HD NICHD NIH HHS; P2C HD065702 United States HD NICHD NIH HHS; U01 AG032947 United States AG NIA NIH HHS
Contributed Indexing:: Keywords: Aging; Back pain; Falls; Functional status; Multimorbidity; Rehabilitation
Molecular Sequence:: ClinicalTrials.gov NCT03632122
Entry Date(s):: Date Created: 20210426 Date Completed: 20210920 Latest Revision: 20220902
Update Code:: 20240105
PubMed Central ID:: PMC8429055
DOI:: 10.1016/j.apmr.2021.03.025
PMID:: 33901438
: Czasopismo naukowe

Objective: To determine the association of chronic conditions measured at baseline with physical performance and falls over time among older adults with back pain. We examined both number and type (depression, anxiety, arthritis) of chronic conditions.
Design: Retrospective cohort study.
Setting: National Health and Aging Trends Study.
Participants: A total of 2438 community-dwelling Medicare beneficiaries aged ≥65 years with bothersome back pain (N=2438). The sample was mostly female (62%; 95% confidence interval [CI], 59%-64%) and aged 65-74 years (56%; 95% CI, 53%-58%).
Interventions: Not applicable.
Main Outcome Measures: Short Physical Performance Battery (SPPB) (range, 0-12, lower indicates worse function) and recurrent falls measured annually over 6 years.
Results: Multiple chronic conditions were highly prevalent (82%; 95% CI, 79%-84%) among those reporting back pain. Adjusted regressions using survey weights with Taylor series linearization method and containing interaction terms for comorbidity and time showed having 2-3 chronic conditions vs 0-1 was associated with lower SPPB scores, and differences grew over time (for example 0.61 points lower [95% CI, -0.88 to -0.34] and 1.22 points lower [95% CI, -1.76 to -0.67] in rounds 3 and 6, respectively). Having ≥4 chronic conditions was associated with lower SPPB scores at all time points vs 0-1 (point estimate range, -1.72 to -2.31). Arthritis alone; the combination of arthritis with depression; and the triad of arthritis, depression, and anxiety were associated with lower SPPB scores at all time points. Logistic regression models showed presence of 2-3 and ≥4 chronic conditions was associated with increased odds of recurrent falls in any given year (odds ratio, 1.91; 95% CI, 1.35-2.69 and odds ratio, 3.92; 95% CI, 2.81-5.46, respectively). Those with the triad of arthritis, depression, and anxiety had greater odds of recurrent falls vs none or 1 condition.
Conclusions: Among older adults with back pain, those with multiple chronic conditions, including co-occurrence of arthritis, depression, and anxiety, have greater risk for poor physical functioning and falls over time.
(Copyright © 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

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