Function and back symptoms in older adults

Objectives: To determine the relationship between back symptoms and limitations in nine specific functional activities. Design: A cross-sectional study. Setting: This study was conducted as part of the Framingham Heart Study, a population-based study performed on a representative sample of community-living residents of Framingham, Massachusetts. Participants: Subjects consisted of 1,007 surviving members of the original cohort who participated in the 22nd Biennial Examination in 1992-93. Ages ranged from 70 to 100. Measurements: Subjects were asked whether they experienced pain, aching, or stiffness in their back on most days and whether they had difficulty performing nine specific functional skills. Odds ratios (ORs) and confidence intervals are reported for the entire sample and within categories of sex. The proportion of functional limitations attributable to back symptoms and the proportion of limitations ascribed by subjects to back symptoms among subjects with these limitations are also reported. Results: The results provide evidence of a relationship between back symptoms and functional limitations. ORs were highest for difficulty standing in one place for about 15 minutes, pushing or pulling a large object, and walking half a mile. Of those with back symptoms, 43% to 63% of limitations in activities were due to back symptoms. Among all subjects, back symptoms were so prevalent that 18% to 34% of all functional limitations were attributable to back symptoms. The association between back symptoms and functional limitations was especially strong in women. Conclusion: Back symptoms account for a large percentage of functional limitations in older adults, especially in women.