Disabling low back pain and depressive symptoms in the community-dwelling elderly: A prospective study

STUDY DESIGN. Analytic cross-sectional and cohort study. OBJECTIVE. This study examines the prevalence and associations of low back pain (LBP) and depressive symptoms in a large population of elderly (65+), community-dwelling subjects. SUMMARY OF BACKGROUND DATA. In adults, depression has been identified as predictive for LBP, while depression has also been found to be a possible consequence of LBP. METHODS. Data of the Health Outcomes Survey that include a baseline (N = 91,347) and a follow-up survey (N = 55,690) after 2 years were analyzed cross-sectionally and prospectively. Degree of depressive symptoms and disabling LBP were described at both time points, as well as their interrelationships. An ordinal logistic regression analysis was performed to model the effects of different sociodemographic, clinical, and functional variables on LBP and depressive symptoms after 2 years. RESULTS. Depressive symptoms were found in about 20% of the sample. Baseline depression symptoms increased the odds of disabling LBP after 2 years independently of sociodemographic characteristics, medical, and functional status. Disabling LBP at baseline increased the odds of depressive symptoms after 2 years to a similar degree. CONCLUSION. Among community-dwelling elderly persons, depressive symptoms and disabling LBP are widespread. Depressive symptoms predict disabling LBP and vice versa. The set of predictors and their extent of contribution to the prognosis are strikingly similar. Research is warranted to identify possible common pathogenic mechanisms or mediating factors.