Non malignant daily pain and risk of disability among older adults in home care in Europe

Department of Gerontology, Catholic University of Sacred Heart, Roma, Italy.
Pain (Impact Factor: 5.21). 07/2007; 129(3):304-10. DOI: 10.1016/j.pain.2006.10.016
Source: PubMed


Aim of the present observational study was to evaluate the association between daily pain and incident disability in elderly subjects living in the community. We used data from the AgeD in HOme Care (AD-HOC) project, a 1 year longitudinal study enrolling subjects aged 65 or older receiving home care in 11 European countries. Daily pain was defined as any type of pain or discomfort in any part of the body manifested every day in the seven days before the baseline assessment. Disability performing activities of daily living (ADLs) was defined as the need of assistance in 1 or more of the following ADL: eating, dressing, transferring, mobility in bed, personal hygiene and toileting. Mean age of 1520 subjects participating the study was 82.1 (standard deviation 6.9) years, and 1178 (77.5%) were women and 695 (45.7%) reported daily pain at the baseline assessment. Overall, 123/825 participants (19.0%) with daily pain and 132/695 (14.9%) without daily pain reported incident disability during the 1 year follow up of the study. After adjustment for potential confounders, participants with daily pain had a significantly higher risk of developing disability, compared with other participants (hazard ratio 1.36; 95% CI: 1.05-1.78). The risk of disability increased with pain severity and with number of painful sites. In conclusion among old subjects living in the community, daily pain is associated with an increased risk of disability.


Available from: Graziano Onder
  • Source
    • "Musculoskeletal disorders such as osteoarthritis of the hip and the knee (hip OA, knee OA), cardiovascular disease, cerebrovascular disease, and respiratory disease may also impact HR-QoL in the elderly [25–28]. Ten experienced orthopedic surgeons judged the existence of hip and knee OA using Altman's criteria [29, 30]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Lumbar spinal stenosis (LSS) is common in the elderly. However, there have been few reports on its impact on quality of life (QoL) in community-dwelling individuals. The purpose of this study was to clarify how symptomatic LSS affects QoL at the community level. A total of 1862 people (697 males and 1165 females, most subjects were between 40 and 85 y.o.) agreed to participate and were interviewed. The presence of symptomatic LSS was assessed by a specially designed questionnaire. The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) was also administered. In addition, the presence of comorbid conditions that affect QoL, such as osteoarthritis of the knee and hip, cardiovascular disease, cerebrovascular disease, or respiratory disease, was also analyzed. The prevalence of symptomatic LSS gradually increased with age. Furthermore, the presence of symptomatic LSS had a strong negative effect on all 8 physical and mental domains and the physical component summary (PCS) (OR: 1.547-2.544) but not the mental component summary (MCS). In comparison with comorbid conditions, LSS had a much stronger negative impact on health-related QoL (HR-QoL). The current study confirmed that the presence of symptomatic LSS might have a strong negative influence on HR-QoL in the community setting.
    The Scientific World Journal 12/2013; 2013(5):590652. DOI:10.1155/2013/590652 · 1.73 Impact Factor
  • Source
    • "It has been estimated that in older populations, the prevalence of pain ranges from 45% to 80%, depending on age, setting, and country of residence [1] [18]. In addition, this condition has been proved to interfere with daily activities, causing depression and emotional distress, thus leading to increased costs related to caregiver burden, long-term institutionalization, and physicians referral [6] [25] [33]. Despite these considerations, pain is frequently 0304-3959/$36.00 "
    [Show abstract] [Hide abstract]
    ABSTRACT: The etiology of behavioral and psychiatric symptoms is generally considered to be multifactorial, and these symptoms often indicate a need for care or assistance, which may include the presence of uncontrolled pain. The aim of this cross-sectional study was to assess the association of pain with behavioral and psychiatric symptoms in a population of nursing home (NH) residents with cognitive impairment in Europe. Data are from the SHELTER project, which contains information on NH residents in 8 countries. Pain was defined as any type of physical pain or discomfort in any part of the body in the 3 days before the assessment. The mean age of 2822 cognitively impaired residents entering the study was 84.1 (standard deviation 9.1)years, and 2110 (74.8%) were women. Of the total sample, 538 residents (19.1%) presented with pain. After adjusting for potential confounders, pain was significantly and positively associated with socially inappropriate behavior (odds ratio [OR] 1.37; 95% confidence interval [CI] 1.04-1.80), resistance to care (OR 1.41; 95% CI 1.08-1.83), abnormal thought process (OR 1.48; 95% CI 1.16-1.90), and delusions (OR 1.48; 95% CI 1.07-2.03). A borderline inverse association was observed with wandering (OR 0.74; 95% CI 0.55-1.00). In conclusion, this cross-sectional study provides evidence from a large sample of frail elderly showing an association between pain and behavioral and psychiatric symptoms. Treatment models that put together assessment and treatment of pain and evaluate their effect on behavioral and psychiatric symptoms are needed.
    Pain 11/2011; 153(2):305-10. DOI:10.1016/j.pain.2011.10.007 · 5.21 Impact Factor
  • Source
    • "Among older persons, pain is a common symptom that can have a serious impact on their mobility (Eggermont et al., 2009; Leveille et al., 2007), functional capacity (Landi et al., 2009; Covinsky et al., 2009; Soldato et al., 2007), and emotional and social wellbeing (van der Waal et al., 2005). Besides its negative implications for the quality of life, pain often adds considerably to health care costs (Mäntyselka et al., 2002). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Pain and factors related to it constitute serious health problems in the older population. This populationbased cross-sectional study aimed to investigate whether musculoskeletal pain is associated with mobility limitation and whether the relationship between pain and mobility limitation varies according to the use of analgesics among community-dwelling older people. A total of 622 community-dwelling participants aged 75 years and older (mean age 80.4, 74% women) were interviewed about presence and severity of musculoskeletal pain. Self-reported analgesic drug utilization was verified against medical records. Mobility limitation was assessed by the Timed Up & Go test (TUG) time of >13.5 s or inability to perform the test. Logistic regression was used to evaluate the pain-affect associations, with associations expressed as odds ratios with 95% confidence intervals (CI). After adjustment for several covariates, musculoskeletal pain remained independently associated with mobility limitation (odds ratio = 1.83; 95% CI 1.16, 2.89). The risk of mobility limitation was highest among those who reported severe or moderate pain (1.84; 1.13, 3.13) and among those who used analgesics (2.37; 1.37, 4.11). In conclusion, musculoskeletal pain increases the risk for mobility limitation. The present findings underline the importance of the careful assessment and pharmacological and nonpharmacological management of pain in promoting mobility in older age.
    European journal of pain (London, England) 06/2011; 16(1):140-9. DOI:10.1016/j.ejpain.2011.05.013 · 2.93 Impact Factor
Show more