Evidence on risk factors for CLBP in elderly adults sparse

Though very common in elderly adults, the factors that contribute to chronic lower back pain (CLBP) are largely understudied, backed by little scientific evidence of high-quality, according to a new meta-analysis.

Drawing from the databases of Medline, Embase, CINAHL, and PsycINFO, this meta-analysis included 10 eligible studies, whose quality of evidence was assessed using the modified Grading of Recommendations Assessments, Development and Evaluation (GRADE) criteria. The risk of bias for cross-sectional and longitudinal studies was assessed using the Appraisal Tool for Cross-Sectional Studies (AXIS) and the Quality in Prognosis Studies (QUIPS) tools, respectively.

The pooled point and 12-month prevalence rates of nonspecific CLBP in elderly adults were 20.6 percent and 36.1 percent, respectively, much higher than in their younger counterparts.

In terms of risk factors, the researchers found 27 potential variables associated with a higher 12-month prevalence of CLBP, though all had either very limited (n=26) or limited (n=1) supporting evidence. Some of these factors were: obesity, anxiety, depression, mental disorders, lifestyle, previous falls, and comorbidities.

All included studies either had high (n=4) or moderate (n=6) risk of bias. Among the common pitfalls for cross-sectional studies included no justification of sample size and no strategy to address nonresponders. For longitudinal studies, lack of details on dropout participants and weak handling of missing data were common problems.

“Given the ageing population and limited information regarding risk factors for CLBP in older adults, future high-quality prospective studies should identify relevant risk factors to help develop proper preventive and treatment strategies,” the researchers said.