School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
School of Public Health, Institute of Bone and Joint Research, Kolling Institute, Sydney Medical School, Sydney, Australia.
Pain. 2017 Aug;158(8):1571-1576. doi: 10.1097/j.pain.0000000000000952.
Older adults are largely under-represented in low back pain (LBP) research. In light of the ageing population, it is crucial to understand the influence of comorbidities and lifestyle factors on the risk and prognosis of LBP in older adults. The aims of this study were to describe the course of LBP in older men; to investigate whether comorbidities/lifestyle factors can predict the course of LBP in older men; to assess if comorbidities/lifestyle factors increase the risk of developing LBP in older men. The study sample comprised 1685 older men living in suburban Sydney, Australia. Low back pain, sociodemographic measures, lifestyle factors, and comorbidities were assessed. Of the 1012 men with LBP at baseline, 58% still reported having pain at the 24-month follow-up. Of those without pain at baseline (n = 673), 28% reported pain at follow-up. The odds of persistent pain at 24 months increased with each additional alcoholic drink/wk (odds ratio [OR] = 1.10, 95% confidence interval [CI]: 1.01-1.22; P = 0.03) and each additional unit of body mass index (OR = 1.28, 95% CI: 1.04-1.60; P = 0.02), but reduced for men who speak English at home (OR = 0.58, 95% CI: 0.35-0.96; P = 0.03). In older men, free of LBP at baseline (n = 673), for every additional comorbidity there was an increased risk of developing LBP (OR = 1.17, 95% CI: 1.00-1.37; P = 0.05). These results demonstrate the influence of lifestyle factors and comorbidities on LBP in older men and suggest that the consideration of these issues in management may improve outcomes.
老年人在腰痛（LBP）研究中代表性不足。鉴于人口老龄化，了解合并症和生活方式因素对老年人 LBP 的风险和预后的影响至关重要。本研究的目的是描述老年男性 LBP 的病程；研究合并症/生活方式因素是否可以预测老年男性 LBP 的病程；评估合并症/生活方式因素是否会增加老年男性患 LBP 的风险。研究样本包括居住在澳大利亚悉尼郊区的 1685 名老年男性。评估了腰痛、社会人口学指标、生活方式因素和合并症。在基线时有 LBP 的 1012 名男性中，58%在 24 个月随访时仍报告有疼痛。在基线时无疼痛的 673 名男性中，28%在随访时报告有疼痛。24 个月时持续性疼痛的几率随每周额外饮酒量的增加而增加（优势比[OR] = 1.10，95%置信区间[CI]：1.01-1.22；P = 0.03）和体重指数每增加一个单位（OR = 1.28，95% CI：1.04-1.60；P = 0.02），但对于在家说英语的男性而言，这种几率降低（OR = 0.58，95% CI：0.35-0.96；P = 0.03）。在基线时无 LBP 的老年男性（n = 673）中，每增加一种合并症，患 LBP 的风险就会增加（OR = 1.17，95% CI：1.00-1.37；P = 0.05）。这些结果表明，生活方式因素和合并症对老年男性 LBP 的影响，并表明在管理中考虑这些问题可能会改善结局。
