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Quantifying Pain Location and Intensity with Multimodal Pain Body Diagrams
Published on: July 7, 2023
Pain as a risk factor for disability or death.
James S Andrews1, Irena Stijacic Cenzer, Edward Yelin
1School of Medicine, Division of Geriatrics, University of California at San Francisco, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA. james.andrews@ucsf.edu
Journal of the American Geriatrics Society
|March 26, 2013
Summary
Significant pain in older adults does not predict future disability or death when functional limitations are considered. Pain and disability may be interrelated geriatric syndromes requiring integrated treatment.
Area of Science:
- Gerontology
- Epidemiology
- Pain Management
Background:
- Pain is prevalent in older adults and often associated with functional decline.
- Understanding the predictive relationship between pain and future disability is crucial for geriatric care.
Purpose of the Study:
- To investigate if significant pain predicts future activities of daily living (ADL) disability or mortality in individuals aged 60 and older.
- To determine the independent risk of pain for subsequent ADL disability or death.
Main Methods:
- A prospective cohort study utilizing data from the Health and Retirement Study (HRS) from 1998 to 2008.
- Included 12,631 community-living older adults without baseline ADL disability, assessing moderate to severe pain.
- Used survival models to analyze the association between pain and incident ADL disability or death over 10 years, adjusting for confounders.
Main Results:
- At baseline, 18% of participants reported significant pain and exhibited more functional limitations.
- Unadjusted analysis showed a higher risk of ADL disability or death in those with pain (HR=1.67).
- After adjusting for demographic factors, chronic conditions, and functional limitations, pain was not a significant predictor of subsequent ADL disability or death (HR=0.98).
Conclusions:
- While pain is strongly associated with functional limitations cross-sectionally, it does not independently predict future ADL disability or mortality.
- Functional limitations largely explain the initial association between pain and adverse outcomes.
- Pain and disability in older adults may be interconnected phenomena requiring unified treatment approaches.
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