Abstract
Back pain (BP) has been rated among the most important factors affecting physical health status in old age. Yet there is an under-representation of the older population in the BP literature. We present extensive interview data from the Longitudinal Study of Aging Danish Twins, dealing with a population-based sample of Danish twins aged 70–102, and describing the 1-month prevalence of BP and the development of BP over time. The associations between BP and education, self-rated health, other health problems, lifestyle factors, and physical and mental function were also investigated. Data were analysed in a cross-sectional analysis for all answers given at entry into the study and in a longitudinal analysis for participants in all four surveys. Associated factors were analysed for the cross-sectional sample using univariate and multivariate analysis accounting for the non-independence of twins in complete pairs. The overall 1-month prevalence of BP was 25% and differed significantly between men and women. The variations in prevalence between the age groups and over time were negligible. The majority of participants in all four surveys had either not experienced BP during the previous month or had done so on one occasion only. Education was not associated with BP. Self-rated health was associated with BP in a significant "dose-response" like pattern. BP was associated with bone and joint disorders, migraine headaches, lung disease, cardiovascular disorders and gastric ulcer, but not neurologic or endocrinologic diseases. BP sufferers had significantly lower scores on physical but not on mental functioning. We conclude that BP is a common symptom in old age; however, the prevalence does not change with increasing age. BP may be part of a more general syndrome of poor health among the old.
Similar content being viewed by others
References
Bergstrom G, Bjelle A, Sundh V, et al (1986) Joint disorders at ages 70, 75 and 79 years—a cross-sectional comparison. Br J Rheumatol 25:333–341
Bigos SJ, Bower O, Braen G (1994) Acute low back problems in adults. Clinical practice guideline no. 14. 95–0642. Agency for Health Care Policy and Research (AHCP), Rockville
Bressler HB, Keyes WJ, Rochon PA, et al (1999) The prevalence of low back pain in the elderly. A systematic review of the literature. Spine 24:1813–1819
Christensen K, Holm NV, McGue M, et al (1999) A Danish population-based twin study on general health in the elderly. J Aging Health 11:49–64
Christensen K, McGue M, Yashin A, et al (2000) Genetic and environmental influences on functional abilities in Danish twins aged 75 years and older. J Gerontol A Biol Sci Med Sci 55:M446-M452
Cooper JK, Kohlmann T (2001) Factors associated with health status of older Americans. Age Ageing 30:495–501
Croft PR, Rigby AS (1994) Socioeconomic influences on back problems in the community in Britain. J Epidemiol Community Health 48:166–170
Dionne CE, Von Korff M, Koepsell TD, et al (2001) Formal education and back pain: a review. J Epidemiol Community Health 55:455–468
Edmond SL, Felson DT (2000) Prevalence of back symptoms in elders. J Rheumatol 27:220–225
Fanuele JC, Birkmeyer NJ, Abdu WA, et al (2000) The impact of spinal problems on the health status of patients: have we underestimated the effect? Spine 25:1509–1514
Folstein MF, Folstein SE, McHugh PR (1975) "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198
Goldberg MS, Scott SC, Mayo NE (2000) A review of the association between cigarette smoking and the development of nonspecific back pain and related outcomes. Spine 25:995–1014
Gyntelberg F (1974) One year incidence of low back pain among male residents of Copenhagen aged 40–59. Dan Med Bull 21:30–36
Hagen KB, Kvien TK, Bjorndal A (1997) Musculoskeletal pain and quality of life in patients with noninflammatory joint pain compared to rheumatoid arthritis: a population survey. J Rheumatol 24:1703–1709
Hauge M, Harvald B, Fisher M (1968) The Danish Twin Register. Acta Genet Med Gemellol 2:315–331
Heliovaara M, Sievers K, Impivaara O, et al (1989) Descriptive epidemiology and public health aspects of low back pain. Ann Med 21:327–333
Huang C, Ross PD, Wasnich RD (1996) Vertebral fractures and other predictors of back pain among older women. J Bone Miner Res 11:1026–1032
Jette AM (1987) The functional status index: reliability and validity of a self-report functional disability measure. J Rheumatol 14 [Suppl 15]:15–19
Joakimsen RM, Berntsen GK, Fonnebo V (2001) Vertebral fractures—a big health problem for elderly women? (in Norwegian, English summary). Tidsskr Nor Laegeforen 121:598–602
Johansson C, Mellstrom D, Rosengren K, et al (1993) Prevalence of vertebral fractures in 85-year-olds. Radiographic examination of 462 subjects. Acta Orthop Scand 64:25–27
Kanis JA, McCloskey EV (1992) Epidemiology of vertebral osteoporosis. Bone 13 [Suppl 2]:1–10
Katz S, Ford AB, Moskowitz RW, et al (1963) Studies of illness in the aged. The index of ADL: a standardized measure of biological and physical function. JAMA 185:94–112
Kauppila LI, McAlindon T, Evans S, et al (1997) Disc degeneration/back pain and calcification of the abdominal aorta. A 25-year follow-up study in Framingham. Spine 22:1642–1647
Lavsky-Shulan M, Wallace RB, Kohout FJ, et al (1985) Prevalence and functional correlates of low back pain in the elderly: the Iowa 65+ Rural Health Study. J Am Geriatr Soc 33:23–28
Leboeuf-Yde C (1999) Smoking and low back pain. A systematic review of 41 journal articles reporting 47 epidemiologic studies. Spine 24:1463–1470
Leboeuf-Yde C, Klougart N, Lauritzen T (1996) How common is low back pain in the Nordic population? Data from a recent study on a middle-aged Danish population and four surveys conducted in the Nordic countries. Spine 21:1518–1525
Leveille SG, Guralnik JM, Hochberg M, et al (1999) Low back pain and disability in older women: independent association with difficulty but not inability to perform daily activities. J Gerontol A Biol Sci Med Sci 54:M487–M493
Loney PL, Stratford PW (1999) The prevalence of low back pain in adults: a methodological review of the literature. Phys Ther 79:384–396
Maniadakis N, Gray A (2000) The economic burden of back pain in the UK. Pain 84:95–103
Manton KG, Corder L, Stallard E (1993) Changes in the use of personal assistance and special equipment from 1982 to 1989: results from the 1982 and 1989 NTLCS. Gerontologist 33:168–176
Schulz-Larsen K, Avlund K, Kreiner S (1992) Functional ability of community dwelling elderly. Criterion-related validity of a new measure of functional ability. J Clin Epidemiol 45:1315–1326
StataCorp (2000) Stata Statistical Software (6.0). Stata Corporation, College Station
Svensson HO, Vedin A, Wilhelmsson C, et al (1983) Low-back pain in relation to other diseases and cardiovascular risk factors. Spine 8:277–285
Vaupel JW, Carey JR, Christensen K, et al (1998) Biodemographic trajectories of longevity. Science 280:855–860
Zetterberg C, Mannius S, Mellstrom D, et al (1990) Osteoporosis and back pain in the elderly. A controlled epidemiologic and radiographic study. Spine 15:783–786
Author information
Authors and Affiliations
Corresponding author
Additional information
Supported by the US National Institute on Aging Research Grant NIA-P01-AG08761, the Danish Research Councils, and the Danish National Research Foundation
Rights and permissions
About this article
Cite this article
Hartvigsen, J., Christensen, K. & Frederiksen, H. Back pain remains a common symptom in old age. A population-based study of 4486 Danish twins aged 70–102. Eur Spine J 12, 528–534 (2003). https://doi.org/10.1007/s00586-003-0542-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-003-0542-y