Epidemiology of back pain in a representative cohort of italian persons 65 years of age and older : The InCHIANTI study

Historically, back pain research has primarily focused on younger, working adults, while little attention was initially given to older persons.1 However, there is evidence that back pain is one of the most frequent complaints in older persons,2,3 and is an independent correlate of functional limitation,4,5 perceived difficulty6 in performing daily life activities, and a risk factor for future disability.7 Studies of younger adults have identified multiple risk factors for back pain, ranging from demographic factors,8 physical and clinical features,9 occupation,10 smoking,11 physical activity,12 and psychologic and socioeconomic conditions,8,13 while comparatively less is known about correlates and risk factors for back pain in older persons. Indeed, most factors identified in the general population as related to back pain are strongly affected by the aging process and, therefore, may have different distributions in older persons.14 Therefore, whether the same factors that predict back pain in younger adults also predict back pain in older persons must be investigated. For instance, job-related features may lose relevance after retirement, while the presence of comorbid conditions may become more important at older ages. Prevalence estimates of back pain in older populations vary widely because of differences in the definition, sampling strategies, and study designs15 that originate from a mix of clinical and administrative reports that only seldom include information on pain location, intensity, and related functional limitations. As the elderly population continues to grow, it will become increasingly important to understand the magnitude of back pain and its associated functional limitations on the health and quality of life of the geriatric population, as well as to identify specific correlates that may be potentially reversible. We used cross-sectional data from the baseline visit of the InCHIANTI study, a clinic-epidemiologic longitudinal survey conducted in Tuscany, Italy, to estimate the prevalence and investigate the characteristics and correlates of back pain in a representative cohort of older Italian persons.