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This study examined the association between back pain in older men and prospective frailty status an average of 7\u2009years later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective cohort study using data from the Osteoporotic Fractures in Men Study. Eligible participants were men who, at study Visit 3 (Year 7), completed a back pain assessment (presence, frequency, severity, activity limitation) and a phenotypic frailty assessment (robust, pre\u2010frail, frail). Among men classified as either robust or pre\u2010frail, phenotypic frailty was again assessed at Visit 4 (Year 14), with deaths between Visits 3 and 4 considered a separate terminal outcome category. The association of Visit 3 back pain with frailty phenotype relative to a robust (and pre\u2010frail) status at Visit 4 was analyzed using multivariable\u2010adjusted multinominal logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5994 men enrolled, 2554 men who were considered robust or pre\u2010frail at Visit 3 (mean [SD] age\u2009=\u200971.6 [4.9] years) were included in the current analysis. After accounting for age, study clinic site, race and education, presence of any back pain, moderate\u2013severe severity, high frequency, and activity limiting back pain were prospectively associated with higher odds of being frail vs. robust and of being frail vs. pre\u2010frail an average of 7\u2009years later. However, after adjustment for other characteristics including prefrail vs. robust status at Visit 3, only the activity\u2010limiting back pain phenotype was associated with significantly higher odds of later being classified as frail vs. prefrail (OR\u2009=\u20091.40 [1.03\u20131.90]), and no back pain phenotypes were associated with higher odds of later being classified as frail vs. robust.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among older community\u2010dwelling men, back pain, particularly activity\u2010limiting back pain, was associated with higher odds of progression to frailty during a 7\u2010year period, suggesting that back pain may be a modifiable risk factor for age\u2010related phenotypic frailty. Further replication and understanding of the mechanisms underpinning the relationship between back pain and frailty are needed to inform targeted interventions in older individuals at risk of frailty.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70755","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T02:45:12Z","timestamp":1791427512000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Back Pain and Prospective Frailty Status Among Older Men: Findings From the\n                    <scp>MrOS<\/scp>\n                    Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5842-877X","authenticated-orcid":false,"given":"David T.","family":"McNaughton","sequence":"first","affiliation":[{"name":"School of Health, Medical and Applied Sciences Central Queensland University  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9069-3036","authenticated-orcid":false,"given":"Kristine","family":"Ensrud","sequence":"additional","affiliation":[{"name":"Medicine and Epidemiology and Community Health University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Langsetmo","sequence":"additional","affiliation":[{"name":"Medicine and Epidemiology and Community Health University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Harrison","sequence":"additional","affiliation":[{"name":"Research Institute California Pacific Medical Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica J.","family":"Wong","sequence":"additional","affiliation":[{"name":"School of Physical Therapy, Faculty of Health Sciences Western University  Canada"},{"name":"Department of Epidemiology and Biostatistics, Schulich School of Medicine &amp; Dentistry Western University  Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier Mu\u00f1oz","family":"Laguna","sequence":"additional","affiliation":[{"name":"Department of Clinical Research University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Young","sequence":"additional","affiliation":[{"name":"Schroeder Arthritis Institute, University Health Network  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"de Luca","sequence":"additional","affiliation":[{"name":"School of Health, Medical and Applied Sciences Central Queensland University  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3993-2385","authenticated-orcid":false,"given":"Tuo\u2010Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute of European and American Studies, Academia Sinica  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazel","family":"Jenkin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney New South Wales Australia"},{"name":"Macquarie University Spinal Pain Research Centre Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron","family":"Downie","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney New South Wales Australia"},{"name":"Macquarie University Spinal Pain Research Centre Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casper","family":"Nim","sequence":"additional","affiliation":[{"name":"Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Thalil","sequence":"additional","affiliation":[{"name":"Department of Human Development and Family Studies Center for Healthy Aging, The Pennsylvania State University  University Park Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy E.","family":"Lane","sequence":"additional","affiliation":[{"name":"Department of Medicine U.C. 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