Back pain trajectories from midlife to retirement as a predictor of old age mobility and disability

• Published in: European journal of public health 2020-09, Vol.30 (Supplement_5)
• Main Authors: Kyrönlahti, S, Nygård, C H, Neupane, S
• Format: Article
• Language: English
• Subjects: Activities of daily living; Age; Aging; Back pain; Chronic conditions; Chronic illnesses; Confidence intervals; Disability; Health education; Low back pain; Middle age; Mobility; Pain; Population studies; Prevention; Public health; Regression analysis; Retirement; Statistical analysis; Well being; Working conditions
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckaa165.1109

Abstract Background Low back pain (LBP) is a leading cause for mobility limitations and disability at older age. However, little is known about the developmental pathways of LBP and its associations with old age mobility and disability. We studied trajectories of LBP from midlife to retirement (16-years follow-up) and assessed the association after 12 years with mobility limitations and disability in activities of daily living (ADL) at old age. Methods Finnish municipal employees were studied at baseline in 1981 and followed for 28 years. A total of 6257 persons aged 44-58 years, answered a questionnaire on health, work ability, and working conditions. Follow-up data on frequency of LBP (never, occasionally, consistently) was collected similarly at four waves. The study population consisted of persons who answered questions about LBP at baseline and at least in one of the follow-up waves and had information about ADL disability (n = 2787) and mobility limitations (n = 2723) at the 28-year follow-up. Latent class growth curve analysis was used to study LBP trajectories. Odds ratios (OR) with their 95% confidence intervals (CIs) for associations of LBP trajectory with ADL disability and mobility limitations were estimated using multivariable logistic regression. Results We identified two trajectories of LBP: high (77%) and low (23%). People in the high trajectory group had 2.35 times higher odds (95% CI 1.88- 2.97) of ADL disability and 1.86 times higher odds (95% CI 1.56-2.22) of mobility limitations as compared to the low trajectory group. Effects were attenuated by adjustment for lifestyle factors and chronic conditions but remained statistically significant for both outcomes [OR 1.74 (95% CI 1.37-2.24) and 1.44 (1.18-1.77), respectively]. Conclusions High LBP experienced during midlife may have far reached consequences on well-being at old age. Prevention of LBP during mid-life could reduce mobility limitations and disability at old age and promote a healthy ageing. Key messages Our results show that low back pain experienced during midlife is associated with mobility limitations and disability in activities of daily living at old age. Our results suggest that emphasis should be put on promotion of musculoskeletal health in midlife as this may help to reduce disability and mobility limitations at old age.