Search PubMed⌕ Search

PubMed · 16547119

Does back pain prevalence really decrease with increasing age? A systematic review.

Abstract

BACKGROUND: It is believed that the prevalence of back pain decreases around the middle of the sixth decade. However, back pain is still among the most commonly reported symptoms in the elderly and osteoarthritis, disc degeneration, osteoporosis and spinal stenosis all increase with age. In light of this, it is difficult to understand why the prevalence of back pain would decrease with increasing age. OBJECTIVE: This study aimed at summarising the scientific evidence on the trends of back pain prevalence with age. METHODS: Population-based studies reporting the prevalence of back pain, including people aged 65 years and over, were systematically retrieved from several bibliographic databases. These were read and assessed by two reviewers, and papers retained ('good quality studies') were aggregated according to specific criteria. RESULTS: Good quality studies showed a large heterogeneity as to their methods and prevalence figures. No specific patterns were detected by country nor outcome measure. However, most studies that considered severe forms of back pain found an increase of prevalence with increasing age. The curvilinear association between age and back pain prevalence that is widely mentioned in the literature was found only for benign and mixed problems. CONCLUSIONS: The evidence concerning the association of back pain prevalence with age is more sparse than currently believed and this association seems to be modified by the severity of the problem. This knowledge could have important public health implications, as the proportion of older people will increase considerably in the coming years in most industrialised societies.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Clermont E Dionne, Kate M Dunn, Peter R Croft. 2006-03-17. Does back pain prevalence really decrease with increasing age? A systematic review.. https://doi.org/10.1093/ageing%2Fafj055

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Retinoblastoma in children older than 5 years of age.

BACKGROUND: Retinoblastoma is a malignant tumor of the embryonic neural retina. About 80% of cases are diagnosed before age 4, with a median age at diagnosis of 2 years. OBJECTIVE: To determine characteristics and prognosis of retinoblastoma in children older than 5 years. PROCEDURES: From 1986 to 2002, medical records of 16 patients out of 453 cases referred to Hospital do Câncer AC Camargo, São Paulo, Brazil. RESULTS: Median age at diagnosis was 73.7 months (range 65-144) and there was an equal gender distribution. Fifteen patients presented with unilateral disease. The mean time between first symptoms and diagnosis was 9.6 months (range 0-48). Most cases were diagnosed in advanced stages and 15 eyes were enucleated. Eleven patients presented with intraocular tumor (1 Reese II and 10 Reese V) and five presented with extraocular disease (one CCG II and four CCG III). Twelve patients are still alive with a median follow-up of 92 months (range 65-199). CONCLUSIONS: Because of its low incidence at this age, diagnosis of retinoblastoma is usually delayed due to low level of suspicion. Therefore, it is important that physicians are aware of this disease in order to perform an earlier diagnosis, and decrease treatment-related morbidity.

Age Distribution↗

Gleason score, age and screening: modeling dedifferentiation in prostate cancer.

Tumor differentiation as measured by the Gleason score is highly predictive of the course of prostatic cancer after diagnosis. Since the introduction of the prostate-specific antigen (PSA) test tumors are diagnosed with a favorable tumor stage and differentiation grade. Does screening with PSA just detect more tumors with favorable characteristics or is dedifferentiation actually being prevented by early detection and consequent treatment? The latter option implies that tumors dedifferentiate in the preclinical screen-detectable phase. To model the natural history of prostate cancer, we analyzed the age-specific distribution of clinical stage and Gleason score of 2,204 tumors diagnosed in the ERSPC-Rotterdam trial. We fitted 2 MISCAN simulation models to the observed data: Model I where tumors dedifferentiate before becoming screen-detectable and Model II where dedifferentiation occurs during the screen-detectable preclinical phase. The hypothesis of dedifferentiation during the screen-detectable phase was tested by a goodness of fit test of both models. In ERSPC-Rotterdam, we observed a significantly more favorable distribution of Gleason scores in screen-detected cancers compared to cancers found in the control arm, and in cancers detected in the second round compared to cancers detected in the first round of screening. Also, a significant association between Gleason score and age at diagnosis was found, most notably in cancers detected in the first round of screening. These findings were reproduced by Model II and less so by Model I, with a significant difference in goodness of fit between the 2 models (p < 0.001). This study provides epidemiological evidence of dedifferentiation as a major mechanism of progression in prostate cancer. Tumors dedifferentiate during the screen-detectable phase and consequently screening with PSA and early treatment can possibly prevent dedifferentiation.

Age Distribution↗

Patterns of symptom distress in older women after surgical treatment for breast cancer.

PURPOSE/OBJECTIVES: To describe patterns of symptom distress over time in older women receiving surgical treatment for breast cancer and to examine the relationship of selected patient and clinical characteristics to symptom distress. DESIGN: Secondary analysis of breast cancer data from a prospective, longitudinal study of older patients with several types of cancer. SETTING: Large mid-Atlantic teaching hospital. SAMPLE: 57 patients with breast cancer participated. Subjects had a mean age of 68 and were predominantly white, not Hispanic, married, Protestant, retired, and in stage I or II. A total of 55 subjects completed the study. METHODS: The Symptom Distress Scale was used. Data were collected on discharge and at three and six months postdischarge. Descriptive statistics, t test, analysis of variance, correlation coefficients, and stepwise multiple regression were analyzed. MAIN RESEARCH VARIABLES: Total symptom distress and 13 individual symptom scores. FINDINGS: Fatigue, frequency of pain, outlook, and insomnia consistently were most prevalent and severe. Symptoms decreased gradually. Younger, more educated, and married women experienced more distress. CONCLUSIONS: Interactions among symptoms are complex. Later symptom distress may be predicted by early experience and demographic characteristics. IMPLICATIONS FOR NURSING: Clinicians should inquire about symptom distress at each encounter, expect multiple symptoms, and anticipate greater symptom distress in patients who are younger, more educated, or married or living with a partner. In women with more severe, earlier symptom distress, nurses should intervene promptly. Research should determine interrelationships of symptoms and how they might be affected by contextual variables, describe critical attributes of the nurse-patient interaction that might mitigate symptom distress, characterize the relationship of symptom intensity and distress, clarify the mechanism of the relationship between marital status and symptom distress, and identify the effect of symptoms, individually and collectively, on survival and quality of life.

Age Distribution↗