Multi-site Pain Is Associated with Long-term Patient-Reported Outcomes in Older Adults with Persistent Back Pain

Pain Medicine ◽  
2019 ◽  
Vol 20 (10) ◽  
pp. 1898-1906 ◽  
Author(s):  
Sean D Rundell ◽  
Kushang V Patel ◽  
Melissa A Krook ◽  
Patrick J Heagerty ◽  
Pradeep Suri ◽  
...  
Keyword(s):  
Older Adults ◽  
Back Pain ◽  
Pain Intensity ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Widespread Pain ◽  
Pain Site ◽  
Multisite Pain ◽  
Persistent Back Pain

AbstractObjectiveTo estimate the prevalence of co-occurring pain sites among older adults with persistent back pain and associations of multisite pain with longitudinal outcomes.DesignSecondary analysis of a cohort study.SettingThree integrated health systems in the United States.SubjectsEight hundred ninety-nine older adults with persistent back pain.MethodsParticipants reported pain in the following sites: stomach, arms/legs/joints, headaches, neck, pelvis/groin, and widespread pain. Over 18 months, we measured back-related disability (Roland Morris, scored 0–24), pain intensity (11-point numerical rating scale), health-related quality of life (EuroQol-5D [EQ-5D], utility from 0–1), and falls in the past three weeks. We used mixed-effects models to test the association of number and type of pain sites with each outcome.ResultsNearly all (N = 839, 93%) respondents reported at least one additional pain site. There were 216 (24%) with one additional site and 623 (69%) with multiple additional sites. The most prevalent comorbid pain site was the arms/legs/joints (N = 801, 89.1%). Adjusted mixed-effects models showed that for every additional pain site, RMDQ worsened by 0.65 points (95% confidence interval [CI] = 0.43 to 0.86), back pain intensity increased by 0.14 points (95% CI = 0.07 to 0.22), EQ-5D worsened by 0.012 points (95% CI = –0.018 to –0.006), and the odds of falling increased by 27% (odds ratio = 1.27, 95% CI = 1.12 to 1.43). Some specific pain sites (extremity pain, widespread pain, and pelvis/groin pain) were associated with greater long-term disability.ConclusionsMultisite pain is common among older adults with persistent back pain. Number of pain sites was associated with all outcomes; individual pain sites were less consistently associated with outcomes.

scholarly journals (366) Multisite pain among older adults with persistent back pain and its association with longitudinal outcomes

2017 ◽  
Vol 18 (4) ◽  
pp. S66 ◽  
Author(s):  
S. Rundell ◽  
K. Patel ◽  
P. Heagerty ◽  
P. Suri ◽  
Z. Bauer ◽  
...  
Keyword(s):  
Older Adults ◽  
Back Pain ◽  
Longitudinal Outcomes ◽  
Multisite Pain ◽  
Persistent Back Pain

Meditation for adults with non-specific low back pain: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Larissa O. Soares ◽  
Giovanni E. Ferreira ◽  
Leonardo O. P. Costa ◽  
Leandro C. Nogueira ◽  
Ney Meziat-Filho ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
Pain Intensity ◽  
Cochrane Library ◽  
Low Back ◽  
Short Term ◽  
Minimal Intervention ◽  
Better Than

Abstract Objectives We aim to determine the effectiveness of meditation for adults with non-specific low back pain. Methods We searched PubMed, EMBASE, PEDro, Scopus, Web of Science, Cochrane Library, and PsycINFO databases for randomized controlled trials that investigated the effectiveness of meditation in adults with non-specific low back pain. Two reviewers rated risk of bias using the PEDro scale and the certainty of the evidence using the GRADE approach. Primary outcomes were pain intensity and disability. Results We included eight trials with a total of 1,234 participants. Moderate-certainty evidence shows that meditation is better than usual care for disability at short-term (SMD = −0.22; 95% CI = −0.42 to −0.02). We also found that meditation is better than usual care for pain intensity at long-term (SMD = −0.28; 95% CI = −0.54 to −0.02). There is no significant difference for pain intensity between meditation and minimal intervention or usual care at short and intermediate-term. We did not find differences between meditation and minimal intervention for disability at intermediate-term or usual care in any follow-up period. Conclusions We found small effect sizes and moderate-certainty evidence that meditation is slightly better than minimal intervention in the short-term for disability. Low-certainty of evidence suggests that meditation is slightly better than usual care for pain in the long-term. Meditation appears to be safe with most trials reporting no serious adverse events.

scholarly journals Impaired olfaction is associated with cognitive decline and neurodegeneration in the brain

Neurology ◽  
2019 ◽  
Vol 92 (7) ◽  
pp. e700-e709 ◽  
Author(s):  
Christina S. Dintica ◽  
Anna Marseglia ◽  
Debora Rizzuto ◽  
Rui Wang ◽  
Janina Seubert ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Mixed Effects ◽  
Olfactory Function ◽  
Mixed Effects Models ◽  
Brain Volumes ◽  
Mri Scans ◽  
Composite Scores ◽  
The Brain ◽  
Smell Identification

ObjectiveWe aimed to examine whether impaired olfaction is associated with cognitive decline and indicators of neurodegeneration in the brain of dementia-free older adults.MethodsWithin the Rush Memory and Aging Project, 380 dementia-free participants (mean age = 78 years) were followed for up to 15 years, and underwent MRI scans. Olfactory function was assessed using the Brief Smell Identification Test (B-SIT) at baseline, and categorized as anosmia (B-SIT <6), hyposmia (B-SIT 6–10 in men and 6–10.25 in women), and normal (B-SIT 10.25–12 in men and 10.5–12 in women). Cognitive function was annually assessed with a battery of 21 tests, from which composite scores were derived. Structural total and regional brain volumes were estimated. Data were analyzed using linear regression and mixed-effects models.ResultsAt study entry, 138 (36.3%) had normal olfactory function, 213 (56.1%) had hyposmia, and 29 (7.6%) had anosmia. In multiadjusted mixed-effects models, hyposmia (β = −0.03, 95% confidence interval [CI] −0.05 to −0.02) and anosmia (β = −0.13, 95% CI −0.16 to −0.09) were associated with faster rate of cognitive decline compared to normal olfaction. On MRI, impaired olfaction (hyposmia or anosmia) was related to smaller volumes of the hippocampus (β = −0.19, 95% CI −0.33 to −0.05), and in the entorhinal (β = −0.16, 95% CI −0.24 to −0.08), fusiform (β = −0.45, 95% CI −0.78 to −0.14), and middle temporal (β = −0.38, 95% CI −0.72 to −0.01) cortices.ConclusionImpaired olfaction predicts faster cognitive decline and might indicate neurodegeneration in the brain among dementia-free older adults.

scholarly journals Association of anticholinergic medications and AD biomarkers with incidence of MCI among cognitively normal older adults

Neurology ◽  
2020 ◽  
Vol 95 (16) ◽  
pp. e2295-e2304 ◽  
Author(s):  
Alexandra J. Weigand ◽  
Mark W. Bondi ◽  
Kelsey R. Thomas ◽  
Noll L. Campbell ◽  
Douglas R. Galasko ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Linear Mixed Effects Models ◽  
Cognitively Normal ◽  
Linear Mixed Effects ◽  
Anticholinergic Medications ◽  
Increased Risk ◽  
Risk Of Progression

ObjectiveTo determine the cognitive consequences of anticholinergic medications (aCH) in cognitively normal older adults as well as interactive effects of genetic and CSF Alzheimer disease (AD) risk factors.MethodsA total of 688 cognitively normal participants from the Alzheimer's Disease Neuroimaging Initiative were evaluated (mean age 73.5 years, 49.6% female). Cox regression examined risk of progression to mild cognitive impairment (MCI) over a 10-year period and linear mixed effects models examined 3-year rates of decline in memory, executive function, and language as a function of aCH. Interactions with APOE ε4 genotype and CSF biomarker evidence of AD pathology were also assessed.ResultsaCH+ participants had increased risk of progression to MCI (hazard ratio [HR] 1.47, p = 0.02), and there was a significant aCH × AD risk interaction such that aCH+/ε4+ individuals showed greater than 2-fold increased risk (HR 2.69, p < 0.001) for incident MCI relative to aCH−/ε4−), while aCH+/CSF+) individuals demonstrated greater than 4-fold (HR 4.89, p < 0.001) increased risk relative to aCH−/CSF−. Linear mixed effects models revealed that aCH predicted a steeper slope of decline in memory (t = −2.35, p = 0.02) and language (t = −2.35, p = 0.02), with effects exacerbated in individuals with AD risk factors.ConclusionsaCH increased risk of incident MCI and cognitive decline, and effects were significantly enhanced among individuals with genetic risk factors and CSF-based AD pathophysiologic markers. Findings underscore the adverse impact of aCH medications on cognition and the need for deprescribing trials, particularly among individuals with elevated risk for AD.

Can sleep quality predict low back pain intensity over time? A longitudinal study with older adults

2019 ◽  
Vol 64 ◽  
pp. S184
Author(s):  
P. Kalil Morelhão ◽  
R. Zambelli Pinto ◽  
C. Gobbi ◽  
M. Rodrigues Franco ◽  
C. Frange ◽  
...  
Keyword(s):  
Older Adults ◽  
Low Back Pain ◽  
Back Pain ◽  
Longitudinal Study ◽  
Sleep Quality ◽  
Pain Intensity ◽  
Low Back ◽  
Over Time

scholarly journals The Effect of Active Plus, a Computer-Tailored Physical Activity Intervention, on the Physical Activity of Older Adults with Chronic Illness(es)—A Cluster Randomized Controlled Trial

2020 ◽  
Vol 17 (7) ◽  
pp. 2590
Author(s):  
Esmee Volders ◽  
Catherine A. W. Bolman ◽  
Renate H. M. de Groot ◽  
Peter Verboon ◽  
Lilian Lechner
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Linear Mixed Effects Models ◽  
Linear Mixed Effects ◽  
Randomized Controlled ◽  
Objectively Measured

eHealth interventions aimed at improving physical activity (PA) can reach large populations with few resources and demands on the population as opposed to centre-based interventions. Active Plus is a proven effective computer-tailored PA intervention for the older adult population focusing on PA in daily life. This manuscript describes the effects of the Active Plus intervention (N = 260) on PA of older adults with chronic illnesses (OACI), compared to a waiting list control group (N = 325). It was part of a larger randomized controlled trial (RCT) on the effects of the Active Plus intervention on cognitive functioning. OACI (≥65 years) with at least one chronic illness were allocated to one of the conditions. Intervention group participants received PA advice. Baseline and follow-up measurements were assessed after 6 and 12 months. Intervention effects on objectively measured light PA (LPA) and moderate-to-vigorous PA (MVPA) min/week were analysed with multilevel linear mixed-effects models adjusted for the clustered design. Intervention effects on self-reported MVPA min/week on common types of PA were analysed with two-part generalized linear mixed-effects models adjusted for the clustered design. The dropout rate was 19.1% after 6 months and 25.1% after 12 months. Analyses showed no effects on objectively measured PA. Active Plus increased the likelihood to perform self-reported cycling and gardening at six months and participants who cycled increased their MVPA min/week of cycling. Twelve months after baseline the intervention increased the likelihood to perform self-reported walking and participants who cycled at 12 months increased their MVPA min/week of cycling. Subgroup analyses showed that more vulnerable participants (higher degree of impairment, age or body mass index) benefitted more from the intervention on especially the lower intensity PA outcomes. In conclusion, Active Plus only increased PA behaviour to a limited extent in OACI 6 and 12 months after baseline measurements. The Active Plus intervention may yet be not effective enough by itself in OACI. A blended approach, where this eHealth intervention and face-to-face contact are combined, is advised to improve the effects of Active Plus on PA in this target group.

(156) Predictors of persistent back pain and persistent disability in older adults with new episodes of back pain

2015 ◽  
Vol 16 (4) ◽  
pp. S15
Author(s):  
S. Rundell ◽  
K. Sherman ◽  
P. Heagerty ◽  
C. Mock ◽  
J. Jarvik
Keyword(s):  
Older Adults ◽  
Back Pain ◽  
Persistent Disability ◽  
Persistent Back Pain
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