{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:28:51Z","timestamp":1759537731682,"version":"build-2065373602"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"10","funder":[{"name":"Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development","award":["#101RX002808"],"award-info":[{"award-number":["#101RX002808"]}]},{"DOI":"10.13039\/100000738","name":"Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Chronic low back pain (CLBP) is a potentially disabling condition that affects an estimated one\u00a0third of older adults. Treatments recommended by existing guidelines result in modest improvements. Identification of modifiable factors that contribute to CLBP-associated disability in older adults is needed to optimize outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Baseline data were analyzed from 275 participants in the Aging Back Clinics trial, which was designed to evaluate the efficacy of a personalized approach to treating CLBP in older veterans. Participants had low back pain of moderate severity on half the days for 6\u2009months or worse, a negative dementia screen, no red flags or history of lumbar surgery, and no communication impairment. Measures included demographics, the Oswestry Disability Index (ODI; main outcome), the NIH Minimal Data Set for CLBP research, the Patient-Reported Outcomes Measurement Information System (PROMIS)-29, medical comorbidity, pain medications, the Medical Outcomes Study social support scale, the Prescribed Opioids Difficulties Scale, and the Pain Self-Efficacy Questionnaire. No disability to minimal disability was defined as ODI\u2009\u2264\u200920, moderate disability as 20\u2009&amp;lt;\u2009ODI\u2009\u2264\u200940, and severe to crippling disability as ODI\u2009&amp;gt;\u200940, to which we fitted a multinomial logistic regression model with a generalized logit link and forward selection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Participants\u2019 average age was 73.5 years, 93% were male, 67% were white, and 28% were black. Approximately 24% reported no disability to mild disability, 50% moderate disability, and 26% severe to crippling disability. Among the 3 modifiable risk factors identified, for each 5-point increase in self-efficacy, there was an \u223c50% lower risk of moderate disability (OR 0.54 [0.42\u20130.69]; P\u2009&amp;lt;\u2009.0001) and an \u223c60% lower risk of severe\/crippling disability (OR 0.39 [0.29\u20130.52]; P\u2009&amp;lt;\u2009.0001). Difficulty falling asleep was associated with more than double the risk of moderate disability (OR 2.48 [1.06\u20135.81]; P\u2009=\u2009.0367) and a nearly 6-fold greater risk of severe\/crippling disability (OR 5.77 [2.09\u201315.96]); P\u2009=\u2009.0007). Each 1-point increase in pain severity was associated with an \u223c1.5-fold increased risk of moderate and severe disability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Low self-efficacy, difficulty falling asleep, and pain severity were identified as independent and potentially modifiable factors associated with CLBP-associated disability risk.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnaf066","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T10:47:55Z","timestamp":1748256475000},"page":"694-701","source":"Crossref","is-referenced-by-count":0,"title":["Correlates of pain-related disability in older veterans with chronic low back pain"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8907-3155","authenticated-orcid":false,"given":"Debra K","family":"Weiner","sequence":"first","affiliation":[{"name":"Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System , Pittsburgh, PA 15240,","place":["United States"]},{"name":"Division of Geriatric Medicine, University of Pittsburgh School of Medicine , Pittsburgh, PA 15213,","place":["United States"]},{"name":"Department of Psychiatry, University of Pittsburgh School of Medicine , Pittsburgh, PA 15213,","place":["United States"]},{"name":"Department of Anesthesiology, University of Pittsburgh School of Medicine , Pittsburgh, PA 15213,","place":["United States"]},{"name":"Clinical and Translational Science Institute, University of Pittsburgh , Pittsburgh, PA 15213,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Gentili","sequence":"additional","affiliation":[{"name":"Central Virginia VA Health Care System , Richmond, VA 23249,","place":["United States"]},{"name":"Division of Geriatric Medicine, Department of Medicine, Virginia Commonwealth University School of Medicine , Richmond, VA 23298,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Garay","sequence":"additional","affiliation":[{"name":"Pain Service, VA Pittsburgh Healthcare System , Pittsburgh, PA 15240,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meika","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System , Los Angeles, CA 90025,","place":["United States"]},{"name":"Department of Medicine, University of California Los Angeles David Geffen School of Medicine , Los Angeles, CA 90095,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lenore","family":"Joseph","sequence":"additional","affiliation":[{"name":"Central Virginia VA Health Care System , Richmond, VA 23249,","place":["United States"]},{"name":"Department of Neurology, Virginia Commonwealth University School of Medicine , Richmond, VA 23298,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Lawson","sequence":"additional","affiliation":[{"name":"Central Virginia VA Health Care System , Richmond, VA 23249,","place":["United States"]},{"name":"Division of Geriatric Medicine, Department of Medicine, Virginia Commonwealth University School of Medicine , Richmond, VA 23298,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cathy C","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California Los Angeles David Geffen School of Medicine , Los Angeles, CA 90095,","place":["United States"]},{"name":"Geriatric Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System , Los Angeles, CA 90025,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Rossi","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System , Pittsburgh, PA 15240,","place":["United States"]},{"name":"Division of Geriatric Medicine, University of Pittsburgh School of Medicine , Pittsburgh, PA 15213,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanlin","family":"He","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, University of Pittsburgh , Pittsburgh, PA 15260,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subashan","family":"Perera","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, University of Pittsburgh School of Medicine , Pittsburgh, PA 15213,","place":["United States"]},{"name":"Department of Biostatistics, University of 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