Impairment in activities of daily living and related factors in elderly patients with severe lumbar spinal stenosis before hospitalization.

Abstract

Background: Lumbar spinal stenosis (LSS) impairs activities of daily living (ADL) in older adults. Factors associated with ADL impairment in LSS have not been identified. This study aimed to ascertain the pre-admission living conditions in elderly patients with LSS and investigate the factors associated with impairment in ADL.

Methods: A total of 261 community-dwelling elderly adults aged ≥65 years with LSS, scheduled for surgery were included. The Oswestry Disability Index (ODI) was used to assess ADL impairment. The Life-Space Assessment was used to assess the extent and frequency of outings. pain, numbness, continuous walking distance, and health-related quality of life as psychosomatic functions. Falls self-efficacy, and the degree of social isolation were assessed as social life status. Factors associated with ADL impairment were examined using multiple logistic regression analysis.

Results: Significant differences were found in psychosomatic functioning, living space, and falls self-efficacy depending on the presence or absence of ADL impairment. The ODI sub-components showed a stronger degree of impairment in pain intensity, walking, standing, and social life. There were significant differences in the frequency of going outside the home and 　inside the neighborhood, ADL impairment was shown to affect the frequency of outings within close proximity to their lives. Numbness was associated with ADL disability (odds ratio, 1.2; 95% confidence interval: 1.1-1.4).

Conclusion: Assessing the degree of numbness is important in predicting ADL impairment in older adults with LSS. Additionally, assessing the living conditions and taking an appropriate approach before admission can help prevent ADL impairment.