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The relationship between back pain and mortality in older adults varies with disability and gender: R esults from the C ambridge C ity over‐75s C ohort ( CC75C ) study
Author(s) -
Docking R.E.,
Fleming J.,
Brayne C.,
Zhao J.,
Macfarlane G.J.,
Jones G.T.
Publication year - 2015
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.568
Subject(s) - hazard ratio , confounding , medicine , confidence interval , demography , disease , association (psychology) , psychology , sociology , psychotherapist
Background This study aims to determine whether older adults reporting back pain ( BP ) are at increased risk of premature mortality, specifically, to examine the association with disabling/non‐disabling pain separately. Methods Participants aged ≥75 years were recruited to the C ambridge C ity over‐75s C ohort ( CC75C ) study. Participants answered interviewer‐administered questions on BP and were followed up until death. The relationship between BP and mortality was examined using C ox regression, adjusted for potential confounding factors. Separate models were computed for men and women. Results From 1174 individuals with BP data, the date of death was known for 1158 (99%). A significant association was found between disabling BP and mortality (hazard ratio: 1.4; 95% confidence interval: 1.1–1.8) and this remained, albeit of borderline significance, following adjustment for socio‐demographic variables and potential disease markers (1.3; 0.99–1.7). Further, this association was found to vary with sex: women experienced a 40% increase in the risk of mortality associated with disabling BP (1.4; 1.1–1.9), whereas no such increase was observed for men (1.0; 0.5–1.9). Participants with non‐disabling BP were not at increased risk of mortality. Conclusions This study confirmed previous findings regarding the relationship between pain and excess mortality. Further, we have shown that, among older adults, this association is specific to disabling pain and to women. Clinicians should be aware not only of the short‐term implications of disabling BP but also the longer‐term effects. Future research should attempt to understand the mechanisms underpinning this relationship to avoid excess mortality and should aim to determine why the relationship differs in men and women.