# Two-years clinical course of pain intensity and symptom satisfaction for latent classes in older adults with back pain

## TL;DR

This study examines how back pain and symptom satisfaction change over two years in older adults, grouped by psychological profiles.

## Contribution

The study identifies distinct psychological groups and their clinical outcomes over time in older adults with back pain.

## Key findings

- The Positive group had the most favorable clinical course for pain and satisfaction.
- The Fearful & Distressed group showed the worst scores throughout the study.
- All groups had similar pain and satisfaction levels at the 2-year endpoint.

## Abstract

Back pain is known to increase with age. However, most studies are conducted in the younger adult population, leaving the older adults understudied. The clinical course and associated prognostic factors for back pain remain poorly investigated in this population. Hence, this study aimed to investigate the clinical course of back pain and symptom satisfaction across groups derived from a latent class analysis in older adults: the Positive, the Fearful, the Distressed, and the Hopeful, over a 2-year period.

Participants were ≥ 55 years of age, seeking primary care due to an episode of back pain. Observational data from baseline and 2-year follow-up was used. Due to similar characteristics between the Fearful and the Distressed groups they were combined. Linear mixed model analyses were conducted, comparing the effect of time and group on pain intensity and symptom satisfaction.

A total of 417 and 275 participants were included at baseline and the 2-year follow-up, respectively. The Positive had a generally more favourable clinical course, the Hopeful showing slightly worse, and the Fearful & Distressed showing the worst scores. However, all groups showed similar levels of pain intensity and symptom satisfaction at the 2-year end point.

Patients with a positive attitude showed lower levels of pain intensity and improved levels of symptom satisfaction throughout most of the study compared to those who were fearful and distressed. Further investigations are needed to explore the effect of actively pursuing a positive outlook during the course of back pain in older adults.

The online version contains supplementary material available at 10.1186/s12891-025-09442-w.