Chronic pain is associated with increased health care use among community-dwelling older adults in Brazil: the Pain in the Elderly (PAINEL) Study

2018 ◽  
Vol 36 (5) ◽  
pp. 594-599 ◽  
Author(s):  
Juliana L Torres ◽  
Silvia L A da Silva ◽  
Fabiane R Ferreira ◽  
Liliane P S Mendes ◽  
Luciana A Machado
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Chronic Pain ◽  
Pain Intensity ◽  
The Elderly ◽  
Population Based ◽  
Community Dwelling ◽  
Health Care Use ◽  
Cross Sectional ◽  
Doctor Visits

Abstract Background Chronic pain is known to increase health care use in high-income countries, but in Brazil, little is known. Objective To investigate the association between chronic pain and health care use among Brazilian older adults and explore the relationship between pain severity and health care use. Methods This cross-sectional study was derived from the population-based study Frailty in Brazilian Older People-FIBRA. Chronic pain, pain intensity and pain-related disability were assessed through additional telephone interviews. Health care use was measured by the number of doctor visits, hospitalization events and high health care use (highest quartile of the distribution for number of doctor visits) in the last 12 months. Associations were tested in regression analyses adjusted for predisposing, enabling and illness-level components from the Andersen Model. Results The 383 participants were predominantly female (71.0%), mean age was 75.6 (6.1 SD). The prevalence of chronic pain was 30.0%. Chronic pain was associated with number of doctor visits [unstandardized B coefficient 1.48; 95% confidence interval (CI) = 0.35–2.62] and high health care use [odds ratios (OR) = 2.27; 95% CI = 1.39–3.72]. Pain intensity was associated with high health care use in univariate (OR = 1.13; 95% CI = 1.06–1.20) but not multivariate analysis (OR = 1.12; 95% CI = 0.94–1.33). Pain-related disability was not associated with any outcome. Conclusion Chronic pain increased health care use among Brazilian older adults. Improving the quality of primary care management of individuals at greater risk of chronic pain should be a cornerstone of health policies directed towards reducing the personal and societal burden of ageing.

Association between Skin Conditions and Depressive Disorders in Community-Dwelling Older Adults

2014 ◽  
Vol 18 (4) ◽  
pp. 256-264 ◽  
Author(s):  
Samantha Gontijo Guerra ◽  
Michel Préville ◽  
Helen-Maria Vasiliadis ◽  
Djamal Berbiche
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Depressive Disorders ◽  
Adult Population ◽  
Community Sample ◽  
The Elderly ◽  
Population Based ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Skin Conditions

Background: Depression is frequently observed in dermatologic patients. However, the association between depressive disorders and skin conditions has rarely been explored through population-based studies, especially within older-adult populations. Objective: To test this association in a representative sample of an older-adult population. Methods: Data came from the Survey on the Health of the Elderly (Enquête sur la Santé des Aînés [ESA]), a longitudinal survey conducted in Quebec among 2,811 older adults. Cross-lagged panel models were used to simultaneously examine cross-sectional and longitudinal relationships between the presence of skin conditions and depressive disorders. Results: The prevalence of skin conditions was 13%, and the prevalence of depressive disorders among participants presenting with skin conditions was 11%. Our results indicated significant cross-sectional correlation ( ζ = 0.20) between skin conditions and depressive disorders, but no longitudinal association was observed. Conclusion: Our results reinforce the hypothesis that skin conditions and depressive disorders are concurrently associated in older adults. However, no evidence of the predictive effect of skin problems on depression (and vice versa) was found in our community sample. Despite the deleterious effect of the coexistence of these problems in older adults, studies are lacking. This article highlights the importance of this issue and emphasizes the need for further research on this topic.

The association between pain characteristics, pain catastrophizing and health care use – Baseline results from the SWEPAIN cohort

2017 ◽  
Vol 16 (1) ◽  
pp. 122-128 ◽  
Author(s):  
Anna Jöud ◽  
Jonas Björk ◽  
Björn Gerdle ◽  
Anna Grimby-Ekman ◽  
Britt Larsson
Keyword(s):  
Health Care ◽  
Pain Intensity ◽  
Pain Catastrophizing ◽  
Population Based ◽  
Cross Sectional Study ◽  
Health Care Use ◽  
Cross Sectional ◽  
Pain Duration ◽  
Care Consultation ◽  
Provide Health Care

AbstractBackground and aimPain is common and adds to the global burden of disease. However, individuals suffering from pain are a heterogeneous group in terms of pain spreading, intensity and duration. While pain influences overall health care consultation not everyone with pain consult health care. To be able to provide health care matching the patients’ needs increased knowledge about what factors determines the decision to consult health care is essential. The aim of this study was to explore the combined importance of pain spreading, intensity, duration and pain catastrophizing for consulting health care.MethodsIn this cross-sectional study we used population based survey data from southeast Sweden (SWEPAIN) including 7792 individuals’ aged 16–85 reporting pain. We used Modified Poisson regressions to analyse factors of importance related to the decision to consult health care.ResultsHigh and moderate pain intensity, as compared to low, increases the probability of consulting health care (High PR = 1.7 [95% CI 1.51–1.88], moderate PR = 1.2 [1.15–1.41]). Having widespread pain, as compared to localised pain, increased the probability of consulting health (PR = 1.2 [1.03–1.36). Pain duration was not associated with increased probability of consulting health care (PR = 1.0 CI0.88–1.07). However an interaction (p = 0.05) between pain duration and pain catastrophizing beliefs was seen indicating a combined importance of the two when consulting health care.ConclusionOur result suggests that pain intensity, pain spreading and pain catastrophizing independently influence the decision to consult health care while there is an interaction effect between pain duration and pain catastrophizing beliefs where the importance of pain catastrophizing believes differ with pain duration; the importance of pain catastrophizing believes differ with pain duration.ImplicationsTreatment and rehabilitation strategies should incorporate this finding in order to meet the individual’s needs focusing on the biopsychosocial model within health care focusing not only on actual pain reliefs but also on for example acceptance and behavioural changes.

scholarly journals The Temporal Relationship between Pain Intensity and Pain Interference and Incident Dementia

2019 ◽  
Vol 16 (2) ◽  
pp. 109-115 ◽  
Author(s):  
Ali Ezzati ◽  
Cuiling Wang ◽  
Mindy J. Katz ◽  
Carol A. Derby ◽  
Andrea R. Zammit ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Pain Intensity ◽  
Primary Outcome Measure ◽  
Community Dwelling ◽  
Pain Interference ◽  
Community Based ◽  
Cross Sectional ◽  
Incident Dementia ◽  
Longitudinal Association

Background: Chronic pain is common among older adults and is associated with cognitive dysfunction based on cross-sectional studies. However, the longitudinal association between chronic pain and incident dementia in community-based samples is unknown. Objective: We aimed to evaluate the association of pain intensity and pain interference with incident dementia in a community-based sample of older adults. Methods: Participants were 1,114 individuals 70 years of age or older from Einstein Aging Study (EAS), a longitudinal cohort study of community-dwelling older adults in the Bronx County, NY. The primary outcome measure was incident dementia, diagnosed using DSM-IV criteria. Pain intensity and interference in the month prior to first annual visit were measured using items from the SF-36 questionnaire. Pain intensity and pain interference were assessed as predictors of time to incident dementia using Cox proportionate hazards models while controlling for potential confounders. Results: Among participants, 114 individuals developed dementia over an average 4.4 years (SD=3.1) of follow-up. Models showed that pain intensity had no significant effect on time to developing dementia, whereas higher levels of pain interference were associated with a higher risk of dementia. In the model that included both pain intensity and interference as predictors of incident dementia, pain interference had a significant effect on incident dementia, and pain intensity remained non-significant. Conclusion: As a potential remediable risk factor, the mechanisms linking pain interference to cognitive decline merit further exploration.

Predictors of Physical Activity Levels in Community-Dwelling Older Adults: A Multivariate Approach Based on a Socio-Ecological Framework

2018 ◽  
Vol 26 (1) ◽  
pp. 114-120 ◽  
Author(s):  
Koren L. Fisher ◽  
Elizabeth L. Harrison ◽  
Brenda G. Bruner ◽  
Joshua A. Lawson ◽  
Bruce A. Reeder ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Environmental Factors ◽  
The Elderly ◽  
Home Care Services ◽  
Community Dwelling ◽  
Nursing Home Care ◽  
Activity Levels ◽  
Inverse Association ◽  
Cross Sectional

The purpose of this study was to explore cross-sectional relationships between self-reported physical activity (PA) and personal, social, and environmental factors in community-dwelling adults aged 50 years and older. Accounting for clustering by neighborhood, generalized estimating equations were used to examine associations between selected correlates and the Physical Activity Scale for the Elderly (PASE) score while adjusting for confounders. Data for 601 participants were analyzed: 79% female, 37% married, mean age 76.8 (± 8.7) years, mean PASE score 112.6 (± 64.8). Age, living in seniors’ housing, using nursing/home care services, receiving encouragement to be active, and having benches available in the neighborhood were inversely associated with PASE. Self-efficacy, SF-12 score, PA barriers, social support, and the presence of trails showed positive associations. Several personal, social, and environmental factors associated with PA were identified. The inverse association between PA and living in seniors’ housing units should be considered when developing PA programs for older adults.

scholarly journals The Effectiveness of a Dyadic Pain Management Program for Community-Dwelling Older Adults with Chronic Pain: A Pilot Randomized Controlled Trial

2020 ◽  
Vol 17 (14) ◽  
pp. 4966
Author(s):  
Ziyan Li ◽  
Mimi Tse ◽  
Angel Tang
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Controlled Trial ◽  
The Elderly ◽  
Management Program ◽  
Community Dwelling ◽  
Control Group ◽  
Pain Management Program ◽  
Community Dwelling Older Adults ◽  
Experimental Group

Background: Chronic pain is a major health problem among older adults and their informal caregivers, which has negative effects on their physical and psychological status. The dyadic pain management program (DPMP) is provided to community-dwelling older adults and informal caregivers to help the dyads reduce pain symptoms, improve the quality of life, develop good exercise habits, as well as cope and break the vicious circle of pain. Methods: A pilot randomized controlled trial was designed and all the dyads were randomly divided into two groups: the DPMP group and control group. Dyads in the DPMP group participated in an 8-week DPMP (4-week face-to-face program and 4-week home-based program), whereas dyads in the control group received one page of simple pain-related information. Results: In total, 64 dyads participated in this study. For baseline comparisons, no significant differences were found between the two groups. After the interventions, the pain score was significantly reduced from 4.25 to 2.57 in the experimental group, respectively. In the repeated measures ANOVA, the differences in pain score (F = 107.787, p < 0.001, d = 0.777) was statistically significant for the group-by-time interaction. After the interventions, the experimental group participants demonstrated significantly higher pain self-efficacy compared with the control group (F = 80.535, p < 0.001, d = 0.722). Furthermore, the elderly increased exercise time significantly (F = 111.212, p < 0.001, d = 0.782) and reported developing good exercise habits. Conclusions: These results provide preliminary support for the effectiveness of a DPMP for relieving the symptoms of chronic pain among the elderly.

scholarly journals A bio-psycho-social approach for frailty amongst Singaporean Chinese community-dwelling older adults – evidence from the Singapore Longitudinal Aging Study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Nigel Teo ◽  
Pei Shi Yeo ◽  
Qi Gao ◽  
Ma Shwe Zin Nyunt ◽  
Jie Jing Foo ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Functional Disability ◽  
Empirical Studies ◽  
Social Contact ◽  
Population Based ◽  
Community Dwelling ◽  
Severe Disability ◽  
Cross Sectional ◽  
Increased Risk

Abstract Background Few empirical studies support a bio-psycho-social conceptualization of frailty. In addition to physical frailty (PF), we explored mental (MF) and social (SF) frailty and studied the associations between multidimensional frailty and various adverse health outcomes. Methods Cross-sectional and longitudinal analyses were conducted using data from a population-based cohort (SLAS-1) of 2387 community-dwelling Singaporean Chinese older adults. Outcomes examined were functional and severe disability, nursing home referral and mortality. PF was defined by shrinking, weakness, slowness, exhaustion and physical inactivity, 1–2 = pre-frail, 3–5 = frail; MF was defined by ≥1 of cognitive impairment, low mood and poor self-reported health; SF was defined by ≥2 of living alone, no education, no confidant, infrequent social contact or help, infrequent social activities, financial difficulty and living in low-end public housing. Results The prevalence of any frailty dimension was 63.0%, dominated by PF (26.2%) and multidimensional frailty (24.2%); 7.0% had all three frailty dimensions. With a few exceptions, frailty dimensions share similar associations with many socio-demographic, lifestyle, health and behavioral factors. Each frailty dimension varied in showing independent associations with functional (Odds Ratios [ORs] = 1.3–1.8) and severe disability prevalence at baseline (ORs = 2.2–7.3), incident functional disability (ORs = 1.1–1.5), nursing home referral (ORs = 1.5–3.4) and mortality (Hazard Ratios = 1.3–1.5) after adjusting for age, gender, medical comorbidity and the two other frailty dimensions. The addition of MF and SF to PF incrementally increased risk estimates by more than 2 folds. Conclusions This study highlights the relevance and utility of PF, MF and SF individually and together. Multidimensional frailty can better inform policies and promote the use of targeted multi-domain interventions tailored to older adults’ frailty statuses.

scholarly journals Is the prevalence of dehydration among community-dwelling older adults really low? Informing current debate over the fluid recommendation for adults aged 70+years

2005 ◽  
Vol 8 (8) ◽  
pp. 1275-1285 ◽  
Author(s):  
Jodi Dunmeyer Stookey ◽  
Carl F Pieper ◽  
Harvey Jay Cohen
Keyword(s):  
Older Adults ◽  
Functional Status ◽  
The Elderly ◽  
Community Dwelling ◽  
Plasma Sodium ◽  
Current Debate ◽  
Creatinine Ratio ◽  
Cross Sectional ◽  
Low Prevalence ◽  
Community Dwelling Older Adults

AbstractObjectiveThe fluid recommendation for adults aged 70+ years has been criticised on the basis of a low prevalence of dehydration in community-dwelling older adults. This study explores whether the low prevalence might reflect limitations of individual dehydration indices.DesignCross-sectional data on plasma sodium, blood urea nitrogen (BUN), creatinine, glucose and potassium were used to classify 1737 participants of the 1992 Established Populations for Epidemiologic Studies of the Elderly (EPESE) (70+ years) according to multiple dehydration indices. Associations between dehydration indices, health and functional status were evaluated.ResultsDepending on the indicator used, the prevalence of dehydration ranged from 0.5% for hypotonic hypovolaemia only (plasma tonicity <285 mOsm l−1 with orthostatic hypotension) to 60% with dehydration defined as either plasma sodium ≥145 mEq l−1, BUN/creatinine ratio ≥20, tonicity ≥295 mOsm l−1, or hypotonic hypovolaemia. Elevated tonicity and BUN/creatinine ratio were respectively associated with chronic disease and functional impairment.ConclusionsThe true prevalence of dehydration among community-dwelling adults may be low or high, depending on the indicator(s) used to define dehydration. Before we can pinpoint a generalisable prevalence of dehydration for community-dwelling seniors and draw conclusions about fluid recommendations, validation studies of dehydration indices and longitudinal studies of dehydration, health and functional status are needed.

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