scholarly journals Stressors and Pain Over the Late-Life Course: Findings from Two Parent Longitudinal Studies of Aging and Health

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 921-922
Author(s):  
Penny Brennan
Keyword(s):  
Life Course ◽  
Longitudinal Studies ◽  
Repeated Measures ◽  
Extended Family ◽  
Late Life ◽  
Pain Severity ◽  
Pain Interference ◽  
Gender And Race ◽  
Rates Of Change ◽  
Aging And Health

Abstract With this study we sought to determine how older adults’ stressors influence their levels and rates of change in pain during the late-life span. We harmonized repeated measures data from two parent longitudinal studies of aging and health, Longitudinal Late-Life Health (LLLH; n=1,1884) and the Health and Retirement Study (HRS; n=7,703), to determine how participants’ stressor levels in the domains of finances, spouse, children, extended family, and friends, and in stressors overall, influenced their average levels and rates of change in painful conditions, pain severity, and pain interference over 13-year (LLLH) and 8-year (HRS) intervals. Participants’ within-person stressor levels declined somewhat, whereas their number of painful conditions, pain severity, pain interference, and prescription painkiller use increased steadily, over these intervals. In both the LLLH and HRS samples, participants who experienced higher average stressor levels over the 13- and 8-year intervals had more numerous painful conditions and higher pain severity over these intervals. In the HRS sample, they also experienced higher levels of pain interference. These effects occurred independent of the demographic characteristics of age, gender, and race. In general, participants’ stressor levels did not influence rates of increase in their pain. Gender and race had some moderating effects on associations between stressors and pain, but these occurred only within certain specific stressor and pain domains. These findings demonstrate an association between stressors and pain across the late-life course. Further research is needed to determine the mediating mechanisms that account for this association and the moderating factors that affect its strength.

Impact of olaparib vs physician’s choice of new hormonal agent (pcNHA) on burden of pain in metastatic castration-resistant prostate cancer (mCRPC): PROfound.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 5538-5538
Author(s):  
Fred Saad ◽  
Guilhem Roubaud ◽  
Giuseppe Procopio ◽  
Neal D. Shore ◽  
Karim Fizazi ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Short Form ◽  
Progression Free Survival ◽  
Pain Severity ◽  
Pain Interference ◽  
Phase Iii ◽  
Castration Resistant Prostate Cancer ◽  
Opiate Use ◽  
Gene Alterations

5538 Background: In the Phase III PROfound study (NCT02987543) olaparib significantly improved radiographic progression-free survival (primary endpoint) vs pcNHA (enzalutamide or abiraterone) in patients (pts) with mCRPC and homologous recombination repair (HRR) gene alterations. In pts with alterations in BRCA1, BRCA2 and/or ATM (cohort A), time to pain progression was also significantly improved by olaparib vs pcNHA. We report additional pain analyses evaluated in the overall study population (cohort A and B). Methods: Pts were randomized to olaparib tablets (300 mg bid; n=256) or pcNHA (n=131). Pts completed the Brief Pain Inventory-Short Form (BPI–SF) questionnaire (electronic administration) every 4 weeks up to 6 months after progression or treatment crossover. Responses were analysed to determine time to progression to worst pain, pain severity and first opiate use for cancer-related pain (Kaplan-Meier), and also pain interference in daily activity (mixed model for repeated measures). Results: 85% and 76% of olaparib pts were free of pain progression (worst pain item) compared with 75% and 51% in the pcNHA arm, respectively at 6 and 12 months. The proportion of pts without pain progression (overall pain severity) also favoured olaparib (Table). Median time to first opiate use was significantly prolonged in olaparib arm compared with pcNHA arm; 18 months for olaparib vs 9 months for pcNHA (Table). BPI-SF pain interference scores were also more favourable for olaparib than pcNHA; difference in overall adjusted mean change from baseline score −0.75 (95% CI: −1.14, −0.36) P=0.0002. Further pain burden results for cohort A will also be presented. Conclusions: Olaparib reduced the burden of pain and time to first opiate use in pts with mCRPC and HRR gene alterations vs pcNHA, demonstrating a clinical and symptomatic patient benefit. Clinical trial information: NCT02987543 . [Table: see text]

scholarly journals Body size throughout the life-course and incident benign prostatic hyperplasia-related outcomes and nocturia

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saira Khan ◽  
K. Y. Wolin ◽  
R. Pakpahan ◽  
R. L. Grubb ◽  
G. A. Colditz ◽  
...  
Keyword(s):  
Body Size ◽  
Benign Prostatic Hyperplasia ◽  
Life Course ◽  
Early Life ◽  
Prostate Volume ◽  
Late Life ◽  
Later Life ◽  
Normal Weight ◽  
Prostatic Hyperplasia ◽  
The Life Course

Abstract Background Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes. Methods Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration > 1.4 ng/mL) were examined using Poisson regression with robust variance estimation. Results Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11–1.40; p-trendfor continuous BMI < 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RRoverweight: 1.13, 95% CI 1.07–1.21; RRobese: 1.10, 95% CI 1.02–1.19; p-trendfor continuous BMI = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RRnormal to overweight: 1.09, 95% CI 0.98–1.22; RRnormal to obese: 1.28, 95% CI 1.10–1.47) and a prostate volume ≥ 30 cc (RRnormal to overweight: 1.12, 95% CI 1.05–1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia. Conclusions We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.

scholarly journals Life-Course Exposure to Early Socioeconomic Environment, Education in Relation to Late-Life Cognitive Function Among Older Mexicans and Mexican Americans

2011 ◽  
Vol 23 (7) ◽  
pp. 1027-1049 ◽  
Author(s):  
Adina Zeki Al Hazzouri ◽  
Mary N. Haan ◽  
Sandro Galea ◽  
Allison E. Aiello
Keyword(s):  
Cognitive Function ◽  
Elementary Education ◽  
Life Course ◽  
Cognitive Aging ◽  
Mexican Americans ◽  
Linear Regression Analysis ◽  
Late Life ◽  
The United States ◽  
Multivariate Linear Regression Analysis ◽  
Z Scores

Objectives: To examine the associations between life-course education and late-life cognitive function along with the modifying role of migration history. Method: The combined sample includes 1,789 participants from the Sacramento Area Latino Study on Aging and 5,253 participants from the Mexican Health and Aging Study. Aged 60+ at baseline, participants were classified as Mexican residents, Mexicans–return migrants, Mexicans–immigrants to the United States, and Mexicans–U.S. born. Cognitive function was measured using standardized z scores of a short-term verbal recall test. Multivariate linear regression analysis was conducted. Results: Participants’ z scores were higher among those whose mother had more than elementary education (β = 0.28, p < .05). Participant’s education mediated this association. For 5-year difference in education, the cognitive z score increased by 0.3 points for a U.S. born. Results were similar with father’s education. Discussion: Adult educational attainment mediates the effect of childhood socioeconomic status on late-life cognition. Migration plays a role in shaping cognitive aging.

A Brief Exploratory Report of Coping Strategies Among Police Recruits During Academy Training

2016 ◽  
Vol 119 (2) ◽  
pp. 557-567 ◽  
Author(s):  
George T. Patterson
Keyword(s):  
Coping Strategies ◽  
Longitudinal Studies ◽  
Repeated Measures ◽  
Work Stressors ◽  
Police Recruits ◽  
Ways Of Coping Questionnaire ◽  
Management Interventions ◽  
Academy Training ◽  
Exploratory Report ◽  
And Coping

Few longitudinal studies have investigated the use of coping strategies among police recruits. This study investigated perceived life and work stressors, appraisal, and coping over a seven-month police recruit academy training program. Participants were 81 police recruits who completed the Ways of Coping Questionnaire at three time points approximately three months apart. The average age of the recruits was 27.6 years ( SD = 5.1, range 20–51). Separate repeated measures analyses of variance were conducted to examine coping scores. Statistically significant decreases, although small, were observed in reported emotion-focused, problem-focused, and seeking social support coping strategies. Results suggested that as police recruits undergo academy training, they rely on fewer coping strategies to deal with life and work stress. More longitudinal studies are needed that assess the methods police recruits utilize to manage stress during academy training. Such results can inform stress management interventions.

scholarly journals Central Sensitization in Neurological, Psychiatric, and Pain Disorders: A Multicenter Case-Controlled Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Keisuke Suzuki ◽  
Yasuo Haruyama ◽  
Gen Kobashi ◽  
Toshimi Sairenchi ◽  
Koji Uchiyama ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Central Sensitization ◽  
Pain Severity ◽  
Pain Interference ◽  
Daily Activities ◽  
Effect Sizes ◽  
Medium Effect ◽  
Controlled Study ◽  
Severity Scores ◽  
The Impact

Background. The role of central sensitization in refractory pain-related diseases has not yet been clarified. Methods. We performed a multicenter case-controlled study including 551 patients with various neurological, psychological, and pain disorders and 5,188 healthy controls to investigate the impact of central sensitization in these patients. Symptoms related to central sensitization syndrome (CSS) were assessed by the Central Sensitization Inventory (CSI) parts A and B. Patients were categorized into 5 groups based on CSI-A scores from subclinical to extreme. The Brief Pain Inventory (BPI), addressing pain severity and pain interference with daily activities, and the Patient Health Questionnaire (PHQ)-9, assessing depressive symptoms, were also administered. Results. CSI-A scores and CSI-B disease numbers were significantly greater in patients than in controls ( p < 0.001 ). Medium effect sizes (r = 0.37) for CSI-A scores and large effect sizes (r = 0.64) for CSI-B disease numbers were found between patients and control groups. Compared with the CSI-A subclinical group, the CSI-A mild, moderate, severe, and extreme groups had significantly higher BPI pain interference and severity scores, PHQ-9 scores, and CSS-related disease numbers based on ANCOVA. Greater CSI-B numbers resulted in higher CSI-A scores ( p < 0.001 ) and a higher odds ratio ( p for trend <0.001). CSS-related symptoms were associated with pain severity, pain interference with daily activities, and depressive symptoms in various pain-related diseases. Conclusions. Our findings suggest that CSS may participate in these conditions as common pathophysiology.

scholarly journals Transpersonal Genetic Effects Among Older U.S. Couples: A Longitudinal Study

2019 ◽  
Vol 76 (1) ◽  
pp. 184-194
Author(s):  
Aniruddha Das
Keyword(s):  
Educational Attainment ◽  
Life Course ◽  
Growth Models ◽  
Late Life ◽  
Genetic Effects ◽  
Genetic Associations ◽  
Individual Level ◽  
Genetics Research ◽  
Nationally Representative ◽  
The Life Course

Abstract Background Emerging social genetics research suggests one’s genes may influence not just one’s own outcomes but also those of close social alters. Health implications, particularly in late life, remain underexplored. Using combined genetic and survey data, this study examined such transpersonal genetic associations among older U.S. couples. Method Data were from married or cohabiting couples in the 2006–2016 waves of the Health and Retirement Study, nationally representative of U.S. adults over 50. Measures included a polygenic score for educational attainment, and self-rated health. Analysis was through parallel process latent growth models. Results Women’s and men’s genetic scores for education had transpersonal linkages with their partner’s health. Such associations were solely with life-course variations and not late-life change in outcomes. Moreover, they were indirect, mediated by educational attainment itself. Evidence also emerged for individual-level genetic effects mediated by the partner’s education. Discussion In addition to the subject-specific linkages emphasized in extant genetics literature, relational contexts involve multiple transpersonal genetic associations. These appear to have consequences for a partner’s and one’s own health. Life-course theory indicates that a person is never not embedded in such contexts, suggesting that these patterns may be widespread. Research is needed on their implications for the life-course and gene–environment correlation literature.

scholarly journals CHRONIC PAIN CONTRIBUTES TO INJURIOUS FALLS IN COMMUNITY-DWELLING OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S622-S622
Author(s):  
Yurun Cai ◽  
Suzanne Leveille ◽  
Ling Shi ◽  
Tongjian You ◽  
Ping Chen
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Community Dwelling ◽  
Pain Severity ◽  
Pain Interference ◽  
Fall Injuries ◽  
Injurious Falls ◽  
Multisite Pain ◽  
Community Dwelling Older Adults ◽  
Pain Distribution

Abstract Fall injuries are a leading cause of death among older adults, and chronic pain has been identified as a fall risk factor. However, the potential impact of chronic pain on injurious falls is unknown. This prospective study examined the relation between chronic pain and injurious falls in a 4-year follow-up of community-dwelling older adults. The MOBILIZE Boston study recruited 765 older adults aged ≥70y living in the Boston area. Pain characteristics, including pain severity, pain interference, and pain location, were measured at baseline using the Brief Pain Inventory subscales and a joint pain questionnaire. Musculoskeletal pain distribution was categorized as “no pain”, “single site pain”, or “multisite pain”. Injurious falls were ascertained in telephone interviews following reports of falls on the monthly fall calendar postcards. The overall rate of injurious falls was 35/100 person-years. Negative binomial models, adjusting for sociodemographics, BMI, chronic conditions, mobility difficulty, analgesic and psychiatric medications, and depression, showed that pain interference and pain distribution, but not pain severity, independently predicted injurious falls. Participants in the highest third of pain interference scores had a 53% greater risk of injurious falls compared to those in the lowest pain interference group (adj.IRR=1.53, 95% CI: 1.15, 2.05). Older adults with multisite pain had a 50% higher risk of injurious falls than those without pain (adj.IRR=1.50, 95% CI: 1.16, 1.93). Risk of injurious falls related to pain was stronger among women than men. Research is needed to determine effective strategies to prevent fall injuries among older adults with chronic pain.

scholarly journals FRAILTY AND PRECARITY: UNTANGLING THE CONCEPTUAL PATHWAYS OF NEED AND DISADVANTAGE IN LATE LIFE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S589-S589
Author(s):  
Amanda M Grenier
Keyword(s):  
Life Course ◽  
Scoping Review ◽  
Late Life ◽  
The State ◽  
Social Gerontology ◽  
Similarities And Differences ◽  
Key Aspects ◽  
The Life Course

Abstract The concepts of frailty and precarity circulate in social gerontology and studies of aging, with the former a dominant construct, and the latter emerging as a way of linking experiences, insecurities and risks. Although these concepts are used inter-changeably by some authors, their roots, key areas of focus and meanings differ. This paper considers the state of knowledge on frailty, and sets this against the uses of precarity. A After outlining a recent scoping review on precarity that revealed a high number of articles cross-referencing concepts of frailty and vulnerability. the paper distinguishes key aspects of frailty, vulnerability, and precarity. Situating qualitative experiences of each serves as a means to further explore similarities and differences. The paper concludes with reflections on what (if anything) each of these allied concepts may offer understandings of late life, and in particular, the study of disadvantage across the life course and into late life.

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