Depressive Symptoms as a Risk Factor for Disabling Back Pain in Community-Dwelling Older Persons

Back pain is a common health problem often associated with substantial disability in older persons, but risk factors for disabling back pain in older persons remain poorly defined. Identifying factors that predict back pain is important, especially those factors that may be amenable to intervention.

The aim of this study was to determine whether the presence of depressive symptoms is an independent risk factor for disabling back pain in older persons. The study, a prospective cohort study with a 12-month follow-up period, followed 744 persons aged 70 and older who were members of a large health plan. Depressive symptoms were present in 20.6 percent of participants at baseline. After adjustment for potential confounders, the study found that the presence of depressive symptoms is a strong, independent and highly prevalent risk factor for the occurrence of disabling back pain in community-dwelling older persons. Some study challenges include disentangling the relationship between depressive symptoms and pain-related disability. For example, disabling back pain may have predated the onset of depressive symptoms for some participants. The results of the current study suggest that disabling back pain may represent a specific pathway through which depressive symptoms lead to physical decline in older persons.