Felício, D.C., Filho, J.E., de Oliveira, T.M.D. et al. Risk factors for non-specific low back pain in older people: a systematic review with meta-analysis. Arch Orthop Trauma Surg (2021). https://doi.org/10.1007/s00402-021-03959-0

Abstract
Purpose
To conduct a systematic review about risk factors associated with non-specific low back pain (LBP) in older people.

Methods
The study protocol was prospectively registered with Prospero (CRD42020191619). This systematic review with meta-analysis included cohort studies that investigated risk factors for LBP in older people. The following databases were searched up to 12 December 2020: MEDLINE (Ovid), Embase, CINAHL, SCOPUS and Web of Science. Two independent reviewers appraised methodological quality using the Critical Appraisal Checklist for Cohort Studies instrument.

Results
We identified 3939 potentially relevant publications. After removing duplicates, screening title, and abstracts, we assessed 86 publications in full text. We included the remaining 11 publications for analysis. There is strong evidence that depressive symptoms are a risk of reporting future back pain onset (I2 = 52,7%, Odds ratio 1.4, CI 1.28–1.53).

Conclusion
Depressive symptoms are a risk factor for LBP in older people. Due to the limitations of the literature, the role of some risk factors remains unclear. An additional high-quality prospective cohort is needed to better elucidate these relationships.