Level of Low Back Pain–Related Disability Is Associated with Risk of Subsequent Falls in an Older Population: Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS)

Author:

Kimachi Kimihiko1,Kimachi Miho1,Takegami Misa2,Ono Rei3,Yamazaki Shin4,Goto Yoshihito5,Onishi Yoshihiro6,Sekiguchi Miho7,Otani Koji7,Konno Shin-ichi7,Kikuchi Shin-ichi7,Fukuhara Shunichi18,Yamamoto Yosuke1

Affiliation:

1. Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan

2. Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan

3. Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan

4. Department of Environmental Epidemiology, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan

5. Department of Community Medicine Supporting System, Kyoto University Graduate School of Medicine, Kyoto, Japan

6. Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan

7. Department of Orthopedic Surgery

8. Center for Innovation in Clinical Research, Fukushima Medical University School of Medicine, Fukushima, Japan

Abstract

Abstract Objectives To examine the longitudinal association between baseline disability due to low back pain (LBP) and future risk of falls, particularly significant falls requiring treatment, in a community-dwelling older population. Methods This was a prospective population-based cohort study using data from the Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS; 2008–2010). A total of 2,738 residents aged ≥60 years were enrolled. LBP was assessed using the Roland-Morris Disability Questionnaire (RMDQ), and the level of LBP-related disability was divided into three categories (none, low, and medium to high). Incidence of falls over the following year was determined using a self-reported questionnaire after the one-year follow-up period. The risk ratio (RR) for LBP-related disability associated with any fall and any fall requiring treatment was estimated using log binomial regression models. Results Data were analyzed for 1,358 subjects. The prevalence of LBP at baseline was 16.4%, whereas 122 (8.9%) participants reported a low level of LBP-related disability and 101 (7.4%) reported medium to high levels of LBP-related disability. Incidence of any fall and falls requiring treatment was reported by 22.1% and 4.6% of participants, respectively. Subjects with medium to high levels of disability were more likely to experience subsequent falls (adjusted RR = 1.53, 95% confidence interval [CI] = 1.21–1.95) and falls requiring treatment (adjusted RR = 2.55, 95% CI = 1.41–4.60) than those with no LBP-related disability. Conclusions Level of LBP-related disability was associated with an increased risk of serious falls in a general population of community-living older adults. These findings can alert health care providers involved in fall prevention efforts to the important issue of activity-related disability due to LBP.

Publisher

Oxford University Press (OUP)

Subject

Anesthesiology and Pain Medicine,Clinical Neurology,General Medicine

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