Ground-breaking research ‘Unlocks spinal health for older Australians’

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Ground-breaking research ‘Unlocks spinal health for older Australians’

Today, the Australian Chiropractors Association (ACA) announced new research outcomes from a 12-month longitudinal study, ‘Back Complaints in the Elderly: Chiropractic – Australia’ (BACE:C-A) at CQUniversity revealing the detrimental impact low back pain (a musculoskeletal disorder) has on the health and wellbeing of older Australians.

The study investigated the clinical course and predictors of disability in older adults with low back pain (LBP) and identified strategies to limit the negative impact it has on older Australians.

Lead Investigator, Associate Professor Katie de Luca found that quality of life, comorbid chronic health conditions and lower leg limb pain all have detrimental effects on the health and wellbeing of older adults.

Concurrent musculoskeletal pain, loss of mobility, frailty, falls, urinary incontinence, poor sleep and disability are all adverse outcomes associated with chronic primary low back pain (CPLBP) in older people.

“Older Australians, particularly those over 65 years, are at high-risk of developing a musculoskeletal disorder including CPLBP which, if untreated can have devastating consequences including reduced physical capabilities, lost independence, social isolation, restricted mobility, disability, and progressive decline in mental capacity,” said A/Prof de Luca.

A recent systematic review found that older people with CPLBP had significantly greater declines in multiple cognitive areas including long-term memory, selective attention, processing speed, and executive function than those who do not have CPLBP.

“The evidence that cognitive functioning declines in older Australians with LBP is concerning,” said A/Prof de Luca.

“Strong evidence suggests depressive symptoms also show a risk of future back pain raising serious concerns about its impact on the mental health of older Australians.”

The research shows that community-dwelling older women with spinal pain have significantly poorer physical and mental health, decreased functional ability and an increased risk of multiple comorbidities (concurrent multiple diseases/disorders) than those without spinal pain.

Diabetes, cardiac disease, pulmonary disease, mental health disorders and obesity were all found to be more common among women with spinal pain than in women without spinal pain, demonstrating that comorbid chronic diseases may contribute to allostatic load (wear and tear on the body).

Over 50% of older women with spinal pain reported 2+ comorbidities. 56% with arthritis had spinal pain in the previous month; 33% had cardiovascular disease; 20% had a mental health disorder, and over 70% were classified as overweight or obese.

LBP is the leading cause of disability world-wide and common in older Australians leading to lost physical and mental capacities, restricted mobility and societal participation with risks of significant comorbidities, higher mortality and decreased health-related quality of life requiring tailored healthcare specific to an individual’s needs.

A/Prof de Luca recently launched the COMEBACK study at CQUniversity to assess the feasibility of adapted exercises for older people with back pain and comorbid conditions.

The findings were significant revealing an overall increase in functional capacity and aerobic stamina, a decrease in depression and anxiety, and importantly, decreased frailty with increased quality of life.

However, evidence suggests common treatments for LBP in the majority of older patient’s conflicts with the recommendations of the WHO guideline.

“Older people are significantly burdened by spinal conditions and a range of additional negative implications associated with back pain that could be effectively treated,” said A/Prof de Luca.

“With 50% of older LBP patients less likely to receive recommendations for exercise than younger patients, in over 55-year-olds medications were recommended for spinal pain in 849 of every 1000 problems.

That’s 85% who could access improved spinal healthcare if the recommended treatments were followed by treating physicians.”

Older Australians are faced with a wide range of potential serious implications including cognitive impairment and physical disability.

Together, with recommendations from the WHO, this research presents a strong argument for improved assessment and treatment options including chiropractic healthcare.

ACA President, Dr David Cahill said, “Having invested over $2.2 million in neuromusculoskeletal research overall, we’re pleased to release A/Prof de Luca’s findings during national Spinal Health Week (20-26 May) which are consistent with interventions endorsed in the WHO guideline including spinal manipulation and exercise,” said Dr Cahill.

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