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

This study aimed to investigate the pre-admission living conditions of elderly patients with LSS and identify factors associated with ADL impairment. By gaining insights into these aspects, healthcare providers can better tailor interventions and support for this vulnerable population.

The study included 261 community-dwelling adults aged 65 or older diagnosed with LSS and scheduled for surgery. ADL impairment was assessed using the Oswestry Disability Index (ODI), with scores ≥40 indicating disability. Various physical, psychological, and social factors were evaluated, including pain intensity, numbness, continuous walking distance, physical component summary (PCS) of health-related quality of life, falls self-efficacy, and social network status. The Life Space Assessment (LSA) was used to assess mobility and social participation. Multiple logistic regression analysis was employed to identify factors associated with ADL impairment, controlling for age, gender, and care insurance status.

Significant differences were found between those with and without ADL impairment in terms of care insurance status, psychosomatic functioning, living space, and fall self-efficacy. ODI sub-components showed greater impairment in pain intensity, walking, standing, and social life for those with ADL disability. The frequency of going outside the home and neighborhood was significantly associated with ADL impairment, with those having ADL disability showing reduced mobility and social participation. Multivariate analysis identified numbness as a factor significantly associated with ADL disability (OR: 1.2, 95% CI: 1.1-1.4), even after adjusting for potential confounders. Surprisingly, other LSS-related symptoms such as pain intensity and reduced walking ability were not independently associated with ADL impairment in the final model.

The study revealed distinct characteristics of ADL impairment in older adults with LSS compared to the general elderly population. Notably, the degree of numbness was found to be a significant predictor of ADL disability, highlighting the importance of this often-overlooked symptom in LSS management. The findings also underscore the complex interplay between physical symptoms, mobility, and social participation in determining ADL function among elderly LSS patients.

Assessing the degree of numbness may be crucial in predicting ADL impairment in older people with LSS. This finding suggests that healthcare providers should pay particular attention to numbness when evaluating LSS patients and planning interventions. Early intervention and appropriate pre-admission approaches are necessary to prevent ADL impairment and maintain quality of life in this population. Future research should focus on developing targeted interventions to address numbness and its impact on ADL in LSS patients.