Back and Neck Pain Exhibit Many Common Features in Old Age: A Population-based Study of 4,486 Danish Twins 70-102 Years of Age

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SOURCE:   Spine 2004 (Mar 1); 29 (5): 576–580

Jan Hartvigsen, DC, PhD, Kaare Christensen, MD, PhD, and Henrik Frederiksen, MD, PhD

Nordic Institute of Chiropractic and Clinical Biomechanics,
Institute of Public Health,
University of Southern Denmark,
Odense C, Denmark.

STUDY DESIGN:   Cross-sectional and longitudinal analysis of data comprising 4,486 Danish twins 70-102 years of age.

OBJECTIVES:   To describe the 1-month prevalence of back pain, neck pain, and concurrent back and neck pain and the development of these over time, associations with other health problems, education, smoking, and physical, and mental functioning.

SUMMARY OF BACKGROUND DATA:   Back pain and neck pain are prevalent symptoms in the population; however, there is little research addressing these conditions in older age groups.

METHODS:   Extensive interview data on health, lifestyle, social, and educational factors were collected in a nationwide cohort-sequential study of 70+ year-old Danish twins. Data for back pain, neck pain, lifetime prevalence of a comprehensive list of diseases, education, and self-rated health were based on self-report. Physical and mental functioning were measured using validated performance tests. Data including associated factors were analyzed in a cross-sectional analysis for answers given at entry into the study, and longitudinal analysis was performed for participants in all four surveys.

RESULTS:   The overall 1-month prevalence for back pain only was 15%, for neck pain only 11%, and for concurrent back and neck pain 11%. The prevalence varied negligibly over time and between the age groups, and 63% of participants in all surveys had no episodes or only one episode of back or neck pain. Back pain and neck pain were associated with a number of other diseases and with poorer self-rated health. Back and neck pain sufferers had significantly lower scores on physical but not cognitive functioning.

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CONCLUSIONS:   Back pain and neck pain are common, intermittent symptoms in old age. Back pain and neck pain are associated with general poor physical health in old age.

KEYWORDS:   back pain, comorbidity, education, geriatrics, neck pain, old age, prevalence, self-rated health]

From the FULL TEXT Article:


Back pain and neck pain are common complaints in the population both with lifetime prevalence rates of roughly 70%. [1, 2] Specific knowledge about back pain and neck pain in seniors is, however, limited, and there is an underrepresentation of older age groups in the back pain literature. [3] Furthermore, it is unknown how back pain and neck pain develop over time in older individuals since no longitudinal studies with repeated identical prevalence measurements in the same cohort have been performed.

There is some evidence that back pain and neck pain may commonly occur together in both younger and older persons. For instance, Cote et al [1] found odds ratios (OR) >20 for severe low back pain in a Canadian population with concurrent severe neck pain, and Isacsson et al found that 23% of retired men in Sweden experienced both back pain and neck pain on a daily basis. [4] In contrast, Brochet et al, in a sample of elderly Frenchmen, found back pain to be almost three times as prevalent as neck pain with very little co-occurrence. [5] It is thus unclear to what extent back pain and neck pain in old age do occur together, and whether they might share common determinants and risk factors or merely occur together occasionally as two common, randomly associated conditions.

We present data from a large population-based prospective cohort study of Danish twins 70 to 102 years of age. We report data describing the 1-month prevalence of back pain, neck pain, and concurrent back pain and neck pain and associations with other health problems, smoking, education, self-rated health, and decreased physical and mental functioning. Further, we describe the development of back pain and neck pain over time both at the group and individual level.

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