ObjectiveThe purpose of this study was to identify social and clinical factors associated with levels of functional disability (FD) in older adults with low back pain (LBP) in the city of Manaus, Amazonas, Brazil. MethodsA cross-sectional study of 557 adults with LBP aged ≥60 years was completed. Sociodemographic and clinical features, pain intensity (Numeric Rating Scale), FD (Roland Morris Disability Questionnaire), physical activity (International Physical Activity Questionnaire-short version), body mass index, educational level, health perception, emotional level, and self-reported diseases were evaluated. Statistical analysis was used to verify the association between quantitative variables and a group; Student t test or Mann-Whitney test, and analysis of variance (normality assumption) or Kruskal-Wallis test (non-parametric), P value of less than .05. ResultsThere were 81.3% female participants, 54.9% self-reported their race and/or skin color as brown, and 37.8% were sedentary. Pain intensity scores were 6.26 ± 2.19 in female participants and 5.82 ± 1.84 in male participants. Mean FD scores were 11.68 ± 6.08 for female participants and 9.61 ± 5.76 for males participants, although 39.7% of the total group presented with severe disability (score ≥14) and FD was associated with female sex (P = .001), physical activity (P≤ 0.001), body mass index (P≤ .001), emotional level (P < .001), and health perception (P < .001). ConclusionIn this group of older adults with LBP, FD was associated with female sex, level of physical activity, body mass index, emotional level, and health perception. Many factors that were identified with FD are modifiable; therefore, interventions, such as nutrition education and re-conceptualization of self-emotional and health perception, may have potential to help in preventing and reducing FD.