Pain Intensity, Disability, and Quality of Life in Patients with Chronic Low Back Pain: Does Age Matter?

Abstract

Objective: Nonspecific chronic low back pain (CLBP) is a frequent medical condition among middle-aged and older adults. Its detrimental consequences for functional ability and quality of life are well known. However, less is known about associations of chronological age with disability and well-being among CLBP patients. Coping with pain may be harder with advancing age due to additional age-associated losses of physical, sensory, and other resources, resulting in higher disability and lower quality of life. Alternatively, older patients may feel less impaired and report higher quality of life than younger patients because the experience of chronic pain may be better anticipated and more "normative" in old age.

Methods: We investigated an age-heterogeneous sample of 228 CLBP patients (mean age = 59.1 years, SD = 10.2 years, range 41-82 years). Our outcomes were pain intensity, pain disability (as assessed by self-reported activity restrictions and performance-based tests), and measures of quality of life (health-related quality of life: SF-12 physical and mental health; well-being: anxiety, depression, perceived control over life, affective distress).

Results: Although older patients had higher performance-based disability, they scored higher on mental health and on most measures of well-being than younger patients.

Conclusions: Our findings provide evidence for a "paradoxical" pattern of age effects in CLBP patients and are thus in line with other studies based on nonclinical samples: Although disability in CLBP patients increases with advancing age, indicators of quality of life are equal or even higher in older patients.

Keywords: Anxiety; Chronic Pain; Depression; Impairment; Mood; Psychology.

Figure 1

Association between age and social and leisure activities. Dots represent the scores of all individuals. Higher scores indicate higher engagement in social and leisure activities (scale range from 0 to 48). The curvilinear association between age (in years) and social and leisure activities is illustrated by the curve indicating that activity engagement is highest at around age 60 years, but lower before and thereafter.

Figure 2

Associations between age and perceived control over life. Dots represent the scores of all individuals. Higher scores indicate higher perceived control over life (scale range from 0 to 18). The curvilinear association between age (in years) and perceived control over life is illustrated by the curve indicating that perceived control over life peaks at an age of about 60–70 years and is lower at older ages as well as in middle adulthood.