Age differences in demographic and clinical characteristics among veterans with chronic low back pain: a cross-sectional study of baseline findings from the Veteran Response to Dosage in Chiropractic Therapy (VERDICT) trial.
Stacie A Salsbury, Cynthia R Long, Jacob McCarey, Anthony J Lisi, Anna Steward, Robert B Wallace, Christine M Goertz
{"title":"Age differences in demographic and clinical characteristics among veterans with chronic low back pain: a cross-sectional study of baseline findings from the Veteran Response to Dosage in Chiropractic Therapy (VERDICT) trial.","authors":"Stacie A Salsbury, Cynthia R Long, Jacob McCarey, Anthony J Lisi, Anna Steward, Robert B Wallace, Christine M Goertz","doi":"10.1186/s12998-025-00613-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Veteran Response to Dosage in Chiropractic Therapy (VERDICT) was a pragmatic randomized trial testing chiropractic dosage effects in 766 veterans with chronic low back pain (CLBP) of ≥ 3 months. This cross-sectional analysis compares baseline characteristics of younger (18-to-64 years) and older veterans (≥ 65 years).</p><p><strong>Methods: </strong>Data were collected from February 22, 2021 to May 21, 2025 via electronic health records and REDCap questionnaires. Descriptive statistics and tests of group differences were performed using SAS.</p><p><strong>Results: </strong>VERDICT enrolled 188 older veterans (25%; mean 72 years) and 578 younger veterans (75%; mean 44 years). More female (24.7% vs. 10.6%, p < .001), Black (18.9% vs. 12.2%), and Hispanic (11.8% vs. 3.7%, p = .001) veterans comprised the younger cohort. Employment differed (p < .001) with older veterans retired (78.2% vs. 14.2%) and younger veterans employed (59% vs. 16.5%). About 14% lived rurally and period of military service was similar. Pain profiles were similar between younger and older veterans for > 5 years duration (78.4% vs. 73.4%), high-impact chronic pain (64.5% vs. 62.2%), mean pain interference [63.8(4.8) vs. 63.2(5.0)], and mean back-related disability (primary outcome) [11.9(5.2) vs. 13.3(4.9)]. Younger veterans scored significantly higher than older veterans for depression (44.8% vs. 31.4%, p = .001), anxiety (41.5% vs. 20.7%, p < .001), post-traumatic stress (38.4% vs. 17.6%, p < .001), sleep disturbance (57.1% vs. 34.6%, p < .001), and high-risk alcohol use (25.4% vs. 18.1%, p = .05). Previous chiropractic use was similar (younger 75.4% vs. older 80.3%). Medications in past 3 months differed with younger veterans reporting cannabis (25.8% vs. 12.8%, p < .001) and muscle relaxants (31.7% vs. 17.6%, p < .001) and more older veterans reporting acetaminophen (63.3% vs. 49.3%, p < .001) and gabapentin (34% vs. 20.1%, p < .001). NSAIDs use was highest among both younger (62.8%) and older (56.9%) veterans. While two-thirds had tried exercise in the past 3 months, only 16% reported exercising for their pain condition, with older veterans more likely to report providers encouraging physical activity.</p><p><strong>Conclusions: </strong>Similar pain profiles were reported among older and younger veterans seeking chiropractic care for CLBP within a clinical trial. However, potentially important age differences were noted in demographics, mental health and substance use, and CLBP treatments.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT04087291. Date of Registration: 9/12/2019. Enrollment Duration: 2/22/2021 (first participant enrolled) through 5/10/2024 (last participant enrolled).</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"33 1","pages":"44"},"PeriodicalIF":2.0000,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516875/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chiropractic & Manual Therapies","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12998-025-00613-z","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Veteran Response to Dosage in Chiropractic Therapy (VERDICT) was a pragmatic randomized trial testing chiropractic dosage effects in 766 veterans with chronic low back pain (CLBP) of ≥ 3 months. This cross-sectional analysis compares baseline characteristics of younger (18-to-64 years) and older veterans (≥ 65 years).
Methods: Data were collected from February 22, 2021 to May 21, 2025 via electronic health records and REDCap questionnaires. Descriptive statistics and tests of group differences were performed using SAS.
Results: VERDICT enrolled 188 older veterans (25%; mean 72 years) and 578 younger veterans (75%; mean 44 years). More female (24.7% vs. 10.6%, p < .001), Black (18.9% vs. 12.2%), and Hispanic (11.8% vs. 3.7%, p = .001) veterans comprised the younger cohort. Employment differed (p < .001) with older veterans retired (78.2% vs. 14.2%) and younger veterans employed (59% vs. 16.5%). About 14% lived rurally and period of military service was similar. Pain profiles were similar between younger and older veterans for > 5 years duration (78.4% vs. 73.4%), high-impact chronic pain (64.5% vs. 62.2%), mean pain interference [63.8(4.8) vs. 63.2(5.0)], and mean back-related disability (primary outcome) [11.9(5.2) vs. 13.3(4.9)]. Younger veterans scored significantly higher than older veterans for depression (44.8% vs. 31.4%, p = .001), anxiety (41.5% vs. 20.7%, p < .001), post-traumatic stress (38.4% vs. 17.6%, p < .001), sleep disturbance (57.1% vs. 34.6%, p < .001), and high-risk alcohol use (25.4% vs. 18.1%, p = .05). Previous chiropractic use was similar (younger 75.4% vs. older 80.3%). Medications in past 3 months differed with younger veterans reporting cannabis (25.8% vs. 12.8%, p < .001) and muscle relaxants (31.7% vs. 17.6%, p < .001) and more older veterans reporting acetaminophen (63.3% vs. 49.3%, p < .001) and gabapentin (34% vs. 20.1%, p < .001). NSAIDs use was highest among both younger (62.8%) and older (56.9%) veterans. While two-thirds had tried exercise in the past 3 months, only 16% reported exercising for their pain condition, with older veterans more likely to report providers encouraging physical activity.
Conclusions: Similar pain profiles were reported among older and younger veterans seeking chiropractic care for CLBP within a clinical trial. However, potentially important age differences were noted in demographics, mental health and substance use, and CLBP treatments.
Trial registration: ClinicalTrials.gov: NCT04087291. Date of Registration: 9/12/2019. Enrollment Duration: 2/22/2021 (first participant enrolled) through 5/10/2024 (last participant enrolled).
背景：老兵对捏脊疗法剂量的反应（VERDICT）是一项实用的随机试验，测试了766名患有慢性腰痛(CLBP)≥3个月的老兵捏脊疗法剂量的影响。本横断面分析比较了年轻（18- 64岁）和老年退伍军人（≥65岁）的基线特征。方法：于2021年2月22日至2025年5月21日通过电子健康记录和REDCap问卷收集数据。采用SAS进行描述性统计和组间差异检验。结果：VERDICT招募了188名老年退伍军人（25%，平均72岁）和578名年轻退伍军人（75%，平均44岁）。更多的女性(24.7% vs. 10.6%， p 5年病程（78.4% vs. 73.4%），高影响慢性疼痛（64.5% vs. 62.2%），平均疼痛干扰[63.8(4.8)vs. 63.2(5.0)]，平均背部相关残疾（主要结局）[11.9(5.2)vs. 13.3(4.9)]。年轻退伍军人抑郁得分明显高于年长退伍军人(44.8% vs. 31.4%, p =。结论：在一项临床试验中，在寻求脊椎指压治疗CLBP的老年和年轻退伍军人中报告了相似的疼痛特征。然而，在人口统计学、心理健康和物质使用以及CLBP治疗方面，潜在的重要年龄差异被注意到。试验注册：ClinicalTrials.gov: NCT04087291。注册日期：2019年9月12日。报名时间：2021年2月22日（首名报名）至2024年5月10日（最后一名报名）。
期刊介绍：
Chiropractic & Manual Therapies publishes manuscripts on all aspects of evidence-based information that is clinically relevant to chiropractors, manual therapists and related health care professionals.
Chiropractic & Manual Therapies is an open access journal that aims to provide chiropractors, manual therapists and related health professionals with clinically relevant, evidence-based information. Chiropractic and other manual therapies share a relatively broad diagnostic practice and treatment scope, emphasizing the structure and function of the body''s musculoskeletal framework (especially the spine). The practices of chiropractic and manual therapies are closely associated with treatments including manipulation, which is a key intervention. The range of services provided can also include massage, mobilisation, physical therapies, dry needling, lifestyle and dietary counselling, plus a variety of other associated therapeutic and rehabilitation approaches.
Chiropractic & Manual Therapies continues to serve as a critical resource in this field, and as an open access publication, is more readily available to practitioners, researchers and clinicians worldwide.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
