Pain and mortality risk among elderly persons in Sweden

The aim of this study is to analyse how the mortality risk varies with mild or severe pain in different locations: chest, back and hips, shoulders, the extremities, abdomen, rectum and head. A Swedish nationally representative sample of 1930 persons born 1892-1915 were interviewed in 1968 (ages 53-76). Survivors were also interviewed in 1974 and 1981 if they had not passed the age of 75 years. Proportional hazard regression was used to analyze mortality risk among persons ages 53-98 years for the period 1968-1991. Relationships were found between mortality risk and headache, chest pain, abdominal pain, pain in the extremities and rectal pain. No relationships were found between mortality and pain in back and hips or in shoulders. There was a correlation between chest pain and increased mortality among both men and women, but the association was significantly stronger among men. There was a significant association between severe rectal pain and mortality among men but no similar association among women. Significant associations between mortality and chest pain and abdominal pain were found among persons younger than 80 years, but not among those older than 80 years. Pain is an indicator of the quality of life and a symptom of underlying medical conditions. The finding that there are relationships between mortality risk and pain in the chest, abdomen, rectum, the extremities and head may be of clinical relevance. These results, however, must be further investigated since the relationships between reported pain and mortality do not imply that pain in these locations is necessarily symptomatic of lethal diseases. Abdominal pain, rectal pain and headache may be indicators of diseases but can also be side effects of treatments for other diseases correlated with higher mortality.