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Pain and mortality: mechanisms for a relationship
Diane Smith1, Ross Wilkie1, Peter Croft1
1Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, United Kingdom.
Pain
|March 24, 2018
Summary
Chronic pain significantly increases mortality risk in older adults. Key mediators include functional limitations, mobility issues, inactivity, and poor self-rated health, suggesting intervention targets for improved survival.
Area of Science:
- Gerontology
- Epidemiology
- Pain Medicine
Background:
- Chronic pain affects 20% of adults, with prevalence increasing with age.
- Interfering chronic pain is linked to increased mortality risk.
- Understanding mediating factors is crucial for developing interventions.
Purpose of the Study:
- To investigate lifestyle, health, social, and psychological factors as mediators between chronic pain and mortality.
- To identify specific pathways through which pain influences long-term survival.
Main Methods:
- Survival analyses, including Cox's proportional hazard modeling and mediation analysis within survival models.
- Utilized data from the English Longitudinal Study of Ageing (n=6324), adults aged 50+.
- Baseline data from wave 2 (2004) with follow-up until 2012.
Main Results:
- Functional limitation (HR 1.31), difficulty walking (HR 1.45), physical inactivity (HR 1.14), and poor self-rated health (HR 1.32) were significant mediators.
- These factors explained a substantial portion of the pain-mortality relationship.
- Pain significantly predicted mortality, mediated by these health and functional factors.
Conclusions:
- Functional limitations, mobility impairments, physical inactivity, and poor self-rated health are key mediators linking chronic pain to mortality.
- These mediators offer targets for preventive health programs aimed at improving long-term survival in older adults with chronic pain.
- Interventions focusing on general health, physical activity, and functional improvement may enhance survival outcomes.
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