The prevalence of pain and pain interference in a general population of older adults: cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP)

Background: Among older adults, pain intensity and pain interference are more common in women than men and associated with obesity and inflammatory markers. Objective: We examined whether the obesity and pain relationship is mediated by the high-sensitivity C-reactive protein (hsCRP), a nonspecific marker of systemic inflammation, and whether this relationship differs by sex. Methods: Items from Medical Outcomes Study Short Form-36 were used to measure pain intensity and pain interference in daily life. Ordinal logistic regression was used to assess the cross-sectional association among body mass index (BMI), hsCRP levels, pain intensity and pain interference using gender-stratified models adjusted for demographic variables. Results: Participants included 667 community-residing adults over the age of 70 years, free of dementia, enrolled in the Einstein Aging Study (EAS). In women (n = 410), pain intensity was associated with obesity [BMI ≥30 vs. normal, odds ratio (OR) = 2.29, 95% confidence interval (CI) 1.43-3.68] and higher hsCRP (OR = 1.28, 95% CI 1.08-1.51). In a model with obesity and hsCRP, both remained significant, but the association between hsCRP and pain intensity was somewhat attenuated. Obesity (OR = 3.04, 95% CI 1.81-5.11) and higher hsCRP levels (OR = 1.30, 95% CI 1.08-1.56) were also independently associated with greater pain interference in women. After adjustment for pain intensity and BMI, hsCRP was no longer associated with pain interference in women. Greater pain intensity and being overweight or obese continued to be significantly associated with pain interference in women. In men (n = 257), obesity and hsCRP were not associated with pain intensity or pain interference. Conclusions: In women, the relationship between obesity and higher levels of pain intensity or interference may be accounted for by factors related to hsCRP.

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The association of loneliness with health and social care utilisation in older adults in the general population: A systematic review

The Gerontologist ◽

10.1093/geront/gnab177 ◽

2021 ◽

Author(s):

Kimberley J Smith ◽

Christina Victor

Keyword(s):

Older Adults ◽

General Population ◽

Social Care ◽

Care Home ◽

Service Utilisation ◽

Study Quality ◽

Cross Sectional ◽

Consistent Finding ◽

Care Utilisation ◽

Health And Social Care

Abstract Background and Objectives Loneliness is proposed to be linked with increased service use. This review examined the association of loneliness and health and social care utilisation (HSCU) in older adults from the general population. Research Design and Methods Four databases were screened for studies that examined the association of loneliness (predictor) with HSCU (outcome) in older adults (defined as majority of sample 60 or older). Study quality was assessed with the NIH scale for observational cohorts and cross-sectional studies. Results We identified 32 studies, of which 9 prospective studies were evaluated as being good or good-fair quality. Two good-fair quality studies found loneliness at baseline was associated with subsequent admission to a residential care home. There was emerging evidence that loneliness was associated with emergency department use (n=1), and CVD-specific hospitalisation (n=1). Once adjusted for confounders the highest quality studies found no association of baseline loneliness with physician utilisation, outpatient service utilisation, skilled nursing facility use, and planned or unplanned hospital admissions. The remaining, studies were cross-sectional, or of fair to poor quality, and inadequate to reliably determine whether loneliness was associated with a subsequent change in HSCU. Discussion and implications There was heterogeneity in study design, measurement, and study quality. This generated an inconsistent evidence base where we cannot determine clear inferences about the relationship between loneliness and HSCU. Only one consistent finding was observed between two good-fair quality studies regarding care home admission. To determine clinical implications and make reliable inferences additional good quality longitudinal research is needed.

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Patient Versus Informal Caregiver Proxy Reports of Pain Interference in Persons With Dementia

Journal of Applied Gerontology ◽

10.1177/0733464820902632 ◽

2020 ◽

pp. 073346482090263 ◽

Cited By ~ 1

Author(s):

Amber B. Amspoker ◽

A. Lynn Snow ◽

Brenna N. Renn ◽

Phoebe Block ◽

Sabrina Pickens ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Informal Caregiver ◽

Pain Interference ◽

Severe Dementia ◽

Proxy Reports ◽

High Prevalence ◽

Assessment And Treatment ◽

Prevalence Of Pain ◽

Caregiver Report

Objectives: Pain assessment and treatment is challenging among persons with dementia (PWDs). To better understand reports of pain interference, we examined ratings made by PWDs, as well as corresponding ratings about PWDs, as reported by the caregiver. We aimed to assess alignment between and predictors of caregiver and PWD report of pain interference. Methods: The sample consisted of 203 veterans with pain and mild to moderately severe dementia and an informal caregiver. Results: Most PWDs and their caregivers reported at least some pain interference and similar levels of pain interference. PWDs with greater cognitive impairment reported less pain interference, whereas caregivers who perceived the PWD to have greater depression reported more pain interference. Conclusions: PWD and caregiver characteristics were differentially associated with PWD versus caregiver report of pain interference. Results suggest the importance of caregiver reports to inform assessment, as well as factors complicating assessment. Pain in Dementia As one ages, the risk of developing both dementia and pain increases substantially (Scherder et al., 2009). It is estimated that 30% to 50% of persons with dementia (PWDs) experience persistent pain, a complex multifactor problem (Corbett et al., 2014). Despite the high prevalence of pain among older adults with dementia, and major advances in pain management, pain often remains unrecognized or undertreated (Hodgson et al., 2014).

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Acute Intermittent Porphyria in the North of China: The Acute Attack Effect on Quality of Life and Psychological Condition

BioMed Research International ◽

10.1155/2018/3216802 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Jing Yang ◽

Tienan Zhu ◽

Yongqiang Zhao ◽

Xuezhong Yu ◽

Huadong Zhu ◽

...

Keyword(s):

Quality Of Life ◽

General Population ◽

Acute Intermittent Porphyria ◽

Autosomal Recessive Disorder ◽

Acute Attack ◽

Cross Sectional ◽

The North ◽

Sf 36 ◽

Impaired Quality

Background. Acute intermittent porphyria (AIP) is an autosomal recessive disorder with intermittent attacks. Patients with AIP are susceptible to impaired quality of life and psychological distress. Objectives. To document the clinical features of AIP and its impact on SF-36 and IES scores of AIP patients in China and to explore the variables associated with SF-36 and IES scores. Methods. A single investigator collated data related to treatments and outcomes in 27 patients with AIP of PUMCH. A cross-sectional questionnaire survey including the SF-36, the IES-R, and demographic questions was conducted in the north of China. Differences in the QoL scale/summary scores and proportions in the QoL dimensions between patients and the general population were analyzed. Independent effects of chronic conditions and demographic variables on the SF-36 and IES-R were analyzed. Results. AIP patients had considerably lower SF-36 scores than the general population (the PF score and MH were lower than normal, P<0.05). Working had higher RP than staying at home (P=0.02); “without acute attack” had higher PF and BP scores and PCS composite score (P=0.001). The mean IES-R score of AIP was higher than normal (36.7±11.8 points, P<0.001), “without acute attack” had lower intrusion score than “with acute attack” (P=0.03). Conclusion. AIP patients in China had impaired quality of life, especially in terms of physical health. The acute attacks coursed the posttraumatic stress disorder-related symptoms.

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Prevalence, Symptoms, and Associated Factors of Chronic Constipation Among Older Adults in North-East of Peninsular Malaysia

Clinical Nursing Research ◽

10.1177/10547738211033934 ◽

2021 ◽

pp. 105477382110339

Author(s):

Patimah Abdul Wahab ◽

Dariah Mohd Yusoff ◽

Azidah Abdul Kadir ◽

Siti Hawa Ali ◽

Lee Yeong Yeh

Keyword(s):

Older Adults ◽

Chronic Constipation ◽

Older Patients ◽

Associated Factors ◽

Cross Sectional Study ◽

Peninsular Malaysia ◽

Plain Water ◽

Cross Sectional ◽

North East ◽

The North

This study aimed to determine the prevalence, symptoms, and associated factors of chronic constipation among older adults in the North-East of Peninsular Malaysia. A cross-sectional study was conducted among older patients from four health clinics. A total of 400 older patients participated, with a mean age of 68.7 ( SD = 6.4) years. The prevalence of chronic constipation was 14.8%. The highest symptom reported was the inability to pass stool (98.3%). Chronic constipation was significantly associated with older age (OR = 2.97; 95% CI [1.17, 7.54]; p = .022), inadequate plain water intake per day (OR = 2.13; 95% CI [1.13, 4.02]; p = .020), hypertension (OR = 2.22; 95% CI [1.07, 4.61]; p = .033), and hyperlipidemia (OR = 2.52; 95% CI [1.24, 5.11]; p = .010). Identification of chronic constipation should be done as part of routine clinic visits, especially for older patients with cardiovascular disease.

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