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A longitudinal age homogeneous cohort study.To describe the prevalence, nature, and predictors of chronic back pain (CBP) in older people.CBP is a growing source of morbidity among the elderly. Few longitudinal studies exist, and its time course and predictors are largely undefined.The Jerusalem Longitudinal Study assessed 277 subjects aged 70 years at baseline and 77 years at follow-up. Data collection included back pain symptoms, psychosocial, functional, and physical domains.The prevalence of CBP increased from 44% to 58% at ages 70 and 77 years, respectively, while frequency and severity decreased. CBP was associated with female gender, economic difficulties, loneliness, fatigue, poor self-rated health, dependence in activities of daily living, joint pain, and obesity. Depression was associated at age 70 years, and unemployment, not leaving the house for leisure, poor sleep satisfaction, hypertension, and osteoporosis were at age 77 years. Predictors of CBP at age 77 years were female gender, loneliness, joint pain, hypertension, and preexisting CBP. Unemployment and not leaving the house for leisure showed a trend toward significance.CBP is increasingly common in the elderly. Psychosocial factors, female gender, hypertension, and existing joint pain identify individuals most at risk.