scholarly journals Locus Coeruleus Integrity in Older Adults with and without Chronic Pain

2021 ◽  
Author(s):  
Tyler R Bell ◽  
Carol E Franz ◽  
Lisa T Eyler ◽  
Christine Fennema-Notestine ◽  
Olivia K Puckett ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Locus Coeruleus ◽  
Bodily Pain ◽  
Pain Scale ◽  
Community Dwelling ◽  
Third Wave ◽  
Sf 36 ◽  
Mri Scans ◽  
Cortical Regions

The locus coeruleus (LC) is a brainstem region involved in regulating pain. Chronic pain is common in older adulthood, but no studies have examined its association with the LC in humans. We used neuromelanin-sensitive imaging to study differences in LC integrity in older adults with and without chronic pain. Chronic pain was assessed in community-dwelling men from the Vietnam Era Twin Study of Aging (VETSA) in 3 study waves covering an average of 12 years. Pain was self-reported on the SF-36 Bodily Pain Scale. Chronic pain was defined as moderate to severe pain severity at the current and at least one prior wave; 17% had chronic pain (n=80). At the third wave, 481 participants (mean age=67.57) underwent neuromelanin-sensitive MRI scans from which we calculated an LC contrast-to-noise ratio (LCCNR) - an index of LC integrity. We examined associations between chronic pain and LCCNR (in the rostral LC and caudal regions) with generalized estimating equations after adjusting for age, race, education, depressive symptoms, medical comorbidities, and opioid medication use. Individuals with chronic pain had .35 standard deviation lower rostral LCCNR (95% CI: -.62 to -.05) compared to those without chronic pain. No differences in the caudal LCCNR were detected. Chronic pain was associated with decreased rostral LC integrity in older adults. Differences in the rostral LC, rather than caudal LC, suggest the association between lower LC integrity and chronic pain may be related to pain processing in cortical regions where rostral LC projections typically connect.

scholarly journals Sleep quality and chronic pain in community dwelling older adults: preliminary results

2020 ◽  
Vol 18 ◽  
pp. 1-7
Author(s):  
Celuane Oliveira Silva ◽  
Glaudson Sá Brandão ◽  
Maria Eduarda Moreira Lino ◽  
Adriano L. Fonseca ◽  
Marcos Mota Silva ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Sleep Quality ◽  
Older People ◽  
Cross Sectional Study ◽  
Pain Scale ◽  
Community Dwelling ◽  
Poor Sleep ◽  
Cross Sectional ◽  
Student’S T

Background: The natural process of human aging causes biopsychosocial alterations, which can trigger chronic pain and poor sleep quality in older adults. Considering the high prevalence and possible association between these two clinical conditions, special attention from public health policies is necessary to provide quality aging. Objective: To verify if there is an association between chronic pain and sleep quality among older adults in the community. Methods: A quantitative, cross-sectional study on the association of chronic pain with the sleep quality among older people in the community. Participants were evaluated using the Pittsburgh Sleep Quality Index (PSQI); Visual Analog Pain scale; questionnaires of sociodemographic and clinical data, assessment of cognitive impairment through the Mini Mental State Examination, and anthropometric assessments. The data were submitted to descriptive statistics. The means between the groups of older people with and without chronic pain were compared using the Student's t test for independent samples and Pearson's correlation coefficient (r) was used to analyze the association of PSQI with pain intensity. Results: In total, 51 older women were included, with a mean age of 70 ± 8 years. The majority had a low level of education (52.9%), low financial income (64.7%), and chronic pain (56.9%). It was found that the older adults with chronic pain presented worse sleep quality when compared those without chronic pain and a moderate (r=0.595) and significant (p<0.01) correlation between sleep quality and the intensity of chronic pain was observed. Conclusion: Older adults in the community with chronic pain present worse sleep quality when compared to the older adults without pain. There is a strong correlation between the intensity of chronic pain and sleep quality in older adults; the greater the intensity of pain, the worse the sleep quality. Trial Registration: Registro Brasileiro de Ensaios Clínicos (REBEC) Identifier: RBR-3cqzfy  

Measuring Pain in Outpatient Surgical Patients: Variation Resulting from Instrument Choice

2012 ◽  
Vol 78 (11) ◽  
pp. 1292-1296 ◽  
Author(s):  
David Goodyear ◽  
Vic Velanovich
Keyword(s):  
Chronic Pain ◽  
Acute Pain ◽  
Linear Regression Analysis ◽  
Bodily Pain ◽  
Pain Scale ◽  
Surgical Patients ◽  
P Value ◽  
Sf 36 ◽  
Chronic Pain Patients ◽  
Pain Patients

Our hypothesis is that the type of instrument will affect variation in pain assessment. A sample of 269 patients administered the visual analog pain scale (VAS) and the generic quality-of-life instrument, and the SF-36 were evaluated for gender, age, the VAS score and the bodily pain domain of the SF-36 (BP-SF-36) score, primary surgical diagnosis, preoperative or postoperative status, and type of operation. Patients were grouped into preoperative (Preop) and postoperative (postop) status and those with chronic pain (CP) conditions and acute/no pain (AP) conditions. Linear regression analysis showed statistically significant (all P value ≤ 0.0006) correlations between the VAS and BP-SF-36 scores all patients, preoperative patients, postoperative patients, acute pain patients, and chronic pain patients. However, the strength of these correlations were moderate (r values between 0.51 and 0.61). Preoperative had more pain compared with postoperative patients as measured by both the VAS and BP-SF-36 ( P = 0.05). Similarly, chronic pain patients had more pain compared with acute pain patients as measured by both scales ( P < 0.0001). Although there are statistically significant associations between the BP-SF-36 and VAS, the correlations are moderate. Different instruments may measure different aspects of pain and the precision with which pain is measured in surgical patients.

scholarly journals Analgesic purchases among older adults – a population-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maiju K. Marttinen ◽  
Hannu Kautiainen ◽  
Maija Haanpää ◽  
Heini Pohjankoski ◽  
Jukka Hintikka ◽  
...  
Keyword(s):  
Older Adults ◽  
Pain Management ◽  
Social Insurance ◽  
Bodily Pain ◽  
Population Based ◽  
Community Dwelling ◽  
Sf 36 ◽  
The Social ◽  
Community Dwelling Older Adults

Abstract Background Pain is a frequent and inevitable factor affecting the quality of life among older people. Several studies have highlighted the ineffectiveness of treating chronic pain among the aged population, and little is known about the prevalence of analgesics administration among community-dwelling older adults. The objective was to examine older adults’ prescription analgesic purchases in relation to SF-36 pain in a population-based setting. Methods One thousand four hundred twenty community-dwelling citizens aged 62–86 years self-reported SF-36 bodily pain (pain intensity and pain-related interference) scores for the previous 4 weeks. The Social Insurance Institution of Finland register data on analgesic purchases for 6 months prior to and 6 months after the questionnaire data collection were considered. Special interest was focused on factors related to opioid purchases. Results Of all participants, 84% had purchased prescription analgesics during 1 year. NSAIDs were most frequently purchased (77%), while 41% had purchased paracetamol, 32% opioids, 17% gabapentinoids, and 7% tricyclic antidepressants. Age made no marked difference in purchasing prevalence. The number of morbidities was independently associated with analgesic purchases in all subjects and metabolic syndrome also with opioid purchases in subjects who had not reported any pain. Discussion Substantial NSAID and opioid purchases emerged. The importance of proper pain assessment and individual deliberation in terms of analgesic contraindications and pain quality, as well as non-pharmacological pain management, need to be highlighted in order to optimize older adults’ pain management.

Pain-related factors in older adults

2019 ◽  
Vol 19 (4) ◽  
pp. 797-803 ◽  
Author(s):  
Maiju K. Marttinen ◽  
Hannu Kautiainen ◽  
Maija Haanpää ◽  
Heini Pohjankoski ◽  
Hanna Vuorimaa ◽  
...  
Keyword(s):  
Older Adults ◽  
Pain Score ◽  
Adult Population ◽  
Bodily Pain ◽  
Age Groups ◽  
Community Dwelling ◽  
Related Factors ◽  
Group I ◽  
Sf 36 ◽  
Pain Prevalence

Abstract Background and aims Pain is an evident factor affecting the quality of life in all age groups. The objective was to examine the prevalence of self-reported SF-36 bodily pain and pain-related factors in community-dwelling older adults. Methods One thousand four hundred and twenty adults aged 62–86 years self-reported SF-36 bodily pain during the previous month. For the analysis, four pain groups were formed (group I [0–45, moderate to very severe pain intensity and interference], group II [47.5–70], group III [77.5–90], and group IV [100, no pain at all]). Additional questionnaire-provided data regarding education, wealth, life habits, and morbidity, as well as clinical data were considered. Results The overall pain prevalence was 78% (SF-36 bodily pain score <100). The prevalence of cohabiting, as well as the years of education and household income were found to decrease with an increasing SF-36 bodily pain score. The prevalence of a BMI of over 30 and of central obesity emerged as the highest in group I. Morbidities were found to be most prevalent in group I. Conclusions A high prevalence of intense and interfering pain was reported. Multiple factors that were found to relate to pain have previously been demonstrated to associate with social exclusion. Increasing attention should be paid to distinguishing these factors in patients with pain, as well as targeted pain assessment and measures to improve the sense of community among older adults. Implications There is a lack of large studies that examine a wide scale of pain-related factors in the older adult population. To distinguish subjects with multiple such factors would help medical professionals to target their attention to patients at a high risk of chronic pain.

scholarly journals The Situated Influence of Chronic Pain Perception on Chinese Older Adults’ Self-Management in Home Care

Geriatrics ◽  
2018 ◽  
Vol 3 (4) ◽  
pp. 64
Author(s):  
Fang Liu ◽  
Min Tong
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Chronic Disease ◽  
Pain Perception ◽  
Community Dwelling ◽  
Self Management ◽  
Chinese Older Adults ◽  
Care Experience ◽  
Management Capacity ◽  
Important Others

Background and objective: Worldwide, 26 million older adults die from chronic disease, and chronic pain is typically a part of the experience of chronic disease. This study explores the perception of chronic pain for home-dwelling Chinese older adults and its influence on (1) self-management ability and (2) management and reduction of chronic pain. Methods: Adopting a qualitative study design, we conducted in-depth interviews with 10 Chinese community-dwelling older adults who experience chronic pain. Half of our informants perceive chronic pain, whereas the other half, diagnosed with Alzheimer’s disease, do not report that they perceive chronic pain. Data were analyzed with inductive thematic analysis. Results: Chronic pain perception plays important roles in (1) defining the challenge of self-management, (2) connecting previous caretaking experience, (3) adjusting the identity of self-management, (4) acquiring support from important others and (5) re-planning self-management arrangements. Conclusion: Pain perception helps to motivate Chinese older adults to face health challenges and regain self-management capacity through adjustments in self-identity and care experience with the support of important others. Pain perception can consolidate the situation of independent living of older adults. It helps to motivate Chinese older adults to face health challenges and regain self-management capacity.

Daily Physical Activity and Functional Disability Incidence in Community-Dwelling Older Adults with Chronic Pain: A Prospective Cohort Study

Pain Medicine ◽  
2018 ◽  
Vol 20 (9) ◽  
pp. 1702-1710 ◽  
Author(s):  
Keitaro Makino ◽  
Sangyoon Lee ◽  
Sungchul Lee ◽  
Seongryu Bae ◽  
Songee Jung ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Chronic Pain ◽  
Functional Disability ◽  
Community Dwelling ◽  
Daily Physical Activity ◽  
Activity Duration ◽  
Intensity Physical Activity ◽  
Physical Activity Duration ◽  
Community Dwelling Older Adults

Abstract Objective This study examined the association between daily physical activity and functional disability incidence in community-dwelling older adults with chronic pain. Design Prospective cohort study. Setting Japanese community. Subjects Of the 5,257 participants enrolled for baseline assessment, data on the 693 participants who had chronic lower back or knee pain and underwent daily physical activity assessment using an accelerometer were analyzed. Methods Participants were assessed for regular physical activity (step counts, moderate- to vigorous-intensity physical activity duration, and light-intensity physical activity duration) using an accelerometer at baseline and were followed up for monthly functional disability incidence, based on the national long-term care insurance system, for approximately two years. We determined the effect of physical activity cutoff points on functional disability incidence using receiver operating characteristic curves and Youden index. Cox proportional hazards regression models were used to analyze associations between the cutoff points and disability incidence. Results Among the 693 participants with chronic pain, 69 (10.0%) developed functional disability during the follow-up period. Participants with lower physical activity levels showed significantly higher risk of disability. After adjusting for all covariates, functional disability was associated with step counts (hazard ratio [HR] = 1.79, 95% confidence interval [CI] = 1.02–3.14) and moderate- to vigorous-intensity physical activity duration (HR = 2.02, 95% CI = 1.16–3.51) but had no relationship with light-intensity physical activity duration (HR = 1.72, 95% CI = 0.97–3.05). Conclusions Maintenance of physical activity with at least moderate intensity may be effective in preventing disability even among older adults with chronic pain.

scholarly journals The type 2 diabetes-specific dementia risk score (DSDRS) is associated with frailty, cognitive and functional status amongst Mexican community-dwelling older adults

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Omar Yaxmehen Bello-Chavolla ◽  
Carlos Alberto Aguilar-Salinas ◽  
José Alberto Avila-Funes
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Community Dwelling ◽  
Related Factors ◽  
Dementia Risk ◽  
Sf 36 ◽  
Community Dwelling Older Adults

Abstract Background The type 2 diabetes (T2D) specific dementia-risk score (DSDRS) was developed to evaluate dementia risk in older adults with T2D. T2D-related factors have been shown increase the risk of age-related conditions, which might also increase dementia risk. Here, we investigate the associations of DSDRS with frailty, disability, quality of life (QoL) and cognition in community-dwelling older adults with T2D. Methods We included 257 community-dwelling older adults with T2D to evaluate the association between DSDRS and Mini-mental state examination (MMSE), Isaac’s set-test (IST), clock drawing test (CDT), quality of life (SF-36), risk of malnutrition (Mini-Nutritional Assessment or MNA), as well as frailty, Katz’ and Lawton-Brody scores. We also assessed the phenotype and correlates of high-estimated dementia risk by assessing individuals with DSDRS >75th age-specific percentiles. Results Mean age of participants was 78.0 ± 6.2 years. DSDRS showed a significant correlation with MMSE test, IST, CDT, SF-36, MNA, Lawton-Brody and Katz scores, and an increasing number of frailty components. DSDRS was higher among frail, pre-frail, and subjects with limited ADL and IADL (p < 0.001). Participants with DSDRS >75th age-specific percentiles had lower education, MMSE, IST, SF-36, MNA, Katz, Lawton-Brody, and higher frailty scores. High-estimated 10-year dementia risk was associated with ADL and IADL disability, frailty and risk of malnutrition. When assessing individual components of DSDRS, T2D-related microvascular complications were associated to all outcome measures. Conclusion The DSDRS is associated with frailty, disability, malnutrition and lower cognitive performance. These findings support that T2D-related factors have significant burden on functional status, QoL, disability and dementia risk.

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.

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