The Onset of Widespread Musculoskeletal Pain Is Associated with a Decrease in Healthy Ageing in Older People: A Population-Based Prospective Study (original) (raw)
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International Journal of Behavioral Medicine, 2003
Using questionnaires, we analyzed associations between different pain variables (e.g., pain intensity) and age (20-65+ years) among 949 primary pain patients. Older patients (a) were more often divorced, were blue-collar workers, were less educated, and had greater difficulties with living expenses; (b) had pain of longer duration, more frequently and of more complexity, and felt more disabled; (c) consumed more painkillers, analgesics, sedatives, and other medications, and had received more pain treatments; and (d) had more health problems. Younger patients had more severe pain, were financially strained, and were more often unemployed. A multivariate regression analysis showed that high disability was more determined by older than young age. However, other factors (e.g., pain complexity) were also important. Thus, older and younger patients experienced their pain differently.
Prevalence and Relevance of Pain in Older Persons
Pain Medicine, 2012
Setting. With the ageing of the world's population, any health problem which adversely affects quality of life in older persons becomes increasingly salient. Persistent pain is one of the most prevalent health conditions faced by adults of advanced age, and is recognized as a major concern for this segment of the population. Results. Numerous epidemiologic surveys suggest that pain is most common during the late middleaged phase of life (55-65 years) and continues at approximately the same prevalence into older age (65+). This is true regardless of the anatomical site or the pathogenic cause of pain. The one exception appears to be pain associated with degenerative joint disease (e.g., osteoarthritis) which shows an exponential increase until at least 90 years of age. Common age associated conditions like dementia may result in a reduced frequency and intensity of pain. Daily pain is a major risk factor for developing disability and the oldest age cohorts are most vulnerable. Discretionary and higher order physical activities appear most affected, while basic activities of daily living may be modified but are rarely ceased altogether. Similar relationships have been documented for risk of depression and mood disturbance in older persons with persistent pain. Despite such well characterized adverse impacts, pain often remains poorly treated in older persons. This occurs across all health care settings examined (i.e., emergency, acute, outpatient, long-term care). Conclusion. Improved knowledge for both health professionals and patients, addressing the current research gaps and expansion of age-appropriate pain management services will be required to better meet the needs of our rapidly ageing population.
Journal of the American Geriatrics Society, 2012
OBJECTIVES: To characterize longitudinal patterns of musculoskeletal pain in a community sample of older adults over a 6-year period and to identify factors associated with persistence of pain. DESIGN: Secondary analysis of the Cardiovascular Health Study. SETTING: Community-based cohort drawn from four U.S. counties. PARTICIPANTS: Five thousand ninety-three men and women aged 65 and older. MEASUREMENTS: Over a 6-year period, pain was assessed each year using a single question about the presence of pain in any bones or joints during the last year. If affirmative, participants were queried about pain in seven locations (hands, shoulders, neck, back, hips, knees, feet). Participants were categorized according to the percentage of time that pain was present and according to the intermittent or chronic pattern of pain. Factors associated with persistent pain during five remaining years of the study were identified. RESULTS: Over 6 years, 32% of participants reported pain for three or more consecutive years, and 32% reported pain intermittently. Of those who reported pain the first year, 54% were pain free at least once during the follow-up period. Most of the pain at specific body locations was intermittent. Factors associated with remission of pain over 5 years included older age, male sex, better self-rated health, not being obese, taking fewer medications, and having fewer depressive symptoms. Approximately half of those with pain reported fewer pain locations the following year. CONCLUSION: Musculoskeletal pain in older adults, despite high prevalence, is often intermittent. The findings refute the notion that pain is an inevitable, unremitting, or progressive consequence of aging.
Pain, 1998
The proportion of people 65 years of age and older who report musculoskeletal pain and physical disability is high. The main objective of this study was to determine whether physical disability was associated with the presence of musculoskeletal pain in a sample of senior citizens. Self-administered questionnaires were sent to a sample of 1306 community-dwelling senior citizens in London, Ontario, Canada between August and October 1995. The questionnaire included questions about pain, difficulty performing activities, depressive symptoms, chronic conditions, and demographic information. A total of 887 seniors completed the questionnaire (70.7% response rate, aged 65-94, 41.2% men, 58.8% women). Logistic regression analysis, without controlling for potential confounding variables, revealed that those who reported having musculoskeletal pain were seven times more likely to have some difficulty performing three or more activities listed in the questionnaire (OR = 6.91 95% CI 4.92-9.69). When significant confounding variables were controlled in the analysis, seniors who reported musculoskeletal pain were still three times more likely to have some difficulty with three or more activities (OR = 2.93, 95% CI 1.96-4.38). Although no causal relationship can be inferred, thorough pain assessment and pain management may be important in the maintenance of independent living for adults 65 years of age or older.
The Impact of Pain on Physical and Mental Quality of Life in Adults 65 and Older
Journal of Gerontological Nursing, 2013
The burden of arthritis, sciatica and back pain on quality of life was estimated using ordinary least squares regression techniques to estimate the impact of each of these types of pain on quality of life, controlling for patient demographic, socioeconomic and health status characteristics. For those with arthritis, sciatica and back pain the adjusted average physical component scores (PCS) were 4.2, 1.4 and 6.8 points lower, respectively (all p < 0.0001).
Arthritis & rheumatology (Hoboken, N.J.), 2014
In older adults, widespread pain (WP) is common, although its etiology is unclear. This study sought to identify factors associated with an increased risk of developing WP in adults age ≥50 years. A population-based prospective study was conducted. A baseline questionnaire was administered to subjects to collect data on pain, psychological status, lifestyle and health behaviors, and sociodemographic and clinical factors. Participants free of WP (as defined by the American College of Rheumatology 1990 criteria for fibromyalgia) were followed up for 3 years, and those with new-onset WP at followup were identified. Logistic regression analyses were used to test the relationship between baseline factors and new-onset WP. Multiple imputation was used to test the results for sensitivity to missing data. In this population-based study, 4,326 subjects (1,562 reporting no pain at baseline and 2,764 reporting some pain at baseline) participated at followup. Of these participants, 800 (18.5%) ...
Physical Therapy Reviews, 2018
Background: Chronic musculoskeletal pain in the elderly is highly prevalent, with osteoarthritis, low back pain, neck pain and other musculoskeletal disorders as the leading contributors to pain chronicity and disability. Previous reviews identifying effective components of non-pharmacological interventions for treating chronic pain have either few studies or the included studies examine outcome over a limited time span. This systematic review will investigate the effectiveness and components of interventions associated with management of chronic musculoskeletal pain in older adults (!65 years). Methods/Design: This systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Randomised controlled trials of non-pharmacological interventions aimed at reducing pain in older adults with chronic musculoskeletal pain will be included. Articles will be identified through a comprehensive search of the following databases: Ovid MEDLINE, Embase, CINAHL, AMED, Scopus, Web of Science and PEDro. Two review authors will independently screen articles retrieved from the search for eligibility, and extract relevant data on methodological issues. A narrative synthesis will be completed if there are insufficient data for a meta-analysis. The narrative synthesis will summarise the current state of knowledge, interventions, study designs and robustness of evidence. Discussion: Findings of the study will inform support programs and interventions to assist people aging with pain, carers and other supporters and practitioners. Systematic review registration: PROSPERO 2017:CRD42017074173.
Health and Quality of Life Outcomes, 2008
Background: Many factors are proposed to be associated with health-related quality of life. Knowledge of health factors associated to development of a good health-related quality of life could be of use in clinical practice and public health work. The aim of this study was to investigate the associations between suggested health factors and health-related quality of life at baseline and in an eight-year follow up in subjects with and without chronic musculoskeletal pain in a cohort from a general population.
The epidemiology of pain in elderly people
Clinics in Geriatric Medicine, 2001
Acute pain probably occurs at much the same rate across all age groups. On the other hand, self-report of chronic pain seems to increase up to, but not beyond, the seventh decade of life. Chronic pain in older people is more often experienced in major joints, the back, legs and feet, whereas visceral pain and headache are reported less often. There is a divergence between an increasing load of pain-associated disease and a plateau of chronic pain complaint in old age that probably reflects impairment in the nociceptive function of the nervous system. However, the contribution of social, behavioral, cognitive, and affective dimensions of the pain experience to this divergence between disease and pain have not been fully evaluated. Most of the answers to these and other questions require longitudinal studies with pain as the predominant focus of attention rather than addressing the symptom of pain as an ancillary measure relevant to other aspects of aging.
Objectives: This study aims to examine age differences in the intensity of chronic pain among middle-aged and older adults, where intensity is measured on a scale differentiating between chronic pain that is often troubling and likely requires intervention versus more endurable sensations. We aim to explore whether individual health and national gross domestic product (GDP) explain these differences as well. Methods: Cross-nationally harmonized data from 20 countries on self-reported intensity of chronic pain (0 = no, 1 = mild, 2 = moderate, 3 = severe) in 104,826 individuals aged 50+ observed in 2012-2013. Two-level hierarchical ordinal linear models with individuals nested within countries were used to isolate estimations from heterogeneity explained by methodological differences across single-country studies. Results: Overall, mean participant age was 66.9 (SD = 9.9), 56.1% were women, and 41.9% of respondents reported any chronic pain. Chronic pain intensity rose sharply with age in some countries (e.g., Korea and Slovenia), but this association waned or reversed in other countries (e.g., the United States and Denmark). Crosscountry variation and age differences in chronic pain were partly explained (85.5% and 35.8%, respectively) by individual-level health (especially arthritis), country-level wealth (as indicated by GDP per capita), and demographics. Discussion: Chronic pain intensity is not an inevitable consequence of chronological age, but the consequence of potential selection effects and lower activity levels combined with individual-level health and country-level wealth. Our ndings suggest further investigation of health conditions and country af uence settings as potential targets of medical and policy interventions aiming to prevent, reduce, or manage chronic pain among older patients and aging populations.