Background & Aims

Low back pain (LBP) is a highly prevalent and disabling condition among older adults. Previous research has linked geriatric LBP with declining physical function, including difficulty in performing activities of daily living. However, factors most studied in relation to declining physical function are low back pain presence and intensity; in contrast, the influence of biopsychosocial factors is poorly understood.

An important social factor to investigate in older adults is partner status. A higher percentage of older adults live alone compared to younger and middle-aged adults. Also, older adults who live alone often present with less education, lower income, and higher depression. Finally, a recent epidemiologic study in older adults found that loneliness was a predictor of persistent LBP. In this exploratory pilot study of older adults with persistent LBP, we investigated living alone in relation to pain, hip strength, and physical function.

Methods

36 older adults with persistent LBP (>3 months) completed demographic, pain, and physical function questionnaires; followed by strength and physical function tests. Current partner status was dichotomized to living alone (single, divorced/separated, widowed) versus living with someone (married, living with a significant other). Pain was measured using the Brief Pain Inventory and self-reported function using the PROMIS Physical Function Shortform (10a). Isometric hip strength (flexion, internal and external rotation) was measured in seated with a handheld dynamometer. Hip strength values were z-transformed and summated to create a hip strength composite score. Lastly, participants performed a 30-second chair rise test and six-minute walk test. Descriptive statistics provided questionnaire scores. Chi-square tests compared frequencies for education and household income. Independent student t tests with Hedges’ (g) effect sizes compared measure scores by current partner status.

Results

Participants were 72 ± 7 years old with a BMI of 31.2 ± 6; 72% identified as female and 31% identified as non-white. Mean pain intensity was 4.3 ± 1.8/10, and self-reported physical function 26 ± 6.6/50; both factors were similar by current partner status (p>0.05). Among participants who lived alone (n=19), 53% reported a household income less than $50k/year; compared to 6% among participants who lived with someone (n=17; x? = 18.6, p<0.001). Comparatively, participants living alone also demonstrated evidence of weaker hip strength (1.9 kgf difference; p=0.083, g = 0.704); performed fewer chair rises (1.6 rise difference; p=0.054, g = 0.656); and walked a shorter distance in six minutes (87-meter difference; p=0.041, g = 0.680).

Conclusions

This preliminary evidence suggests that among older adults with persistent LBP, those who live alone may have a lower household income, and present with less strength and physical function, than those who live with someone.

References

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Presenting Author

Corey Simon

Poster Authors

Corey Simon, PT, DPT, PhD

DPT, PhD

Department of Orthopaedic Surgery, Duke University, North Carolina, USA

Lead Author

Bonnie Leung

B.S.

Duke University

Lead Author

Juliana Ancalmo

B.S.

Duke University

Lead Author

Gregory Hicks

University of Delaware

Lead Author

Cathleen Colón-Emeric

MD

Duke University

Lead Author

Topics

  • Mechanisms: Psychosocial and Biopsychosocial