Impact of pain on self-rated health in the community-dwelling older adults

Abstract

This study examined the impact of pain on self-rated health status in the community-dwelling older adults using the 1993 public release data of the Asset and Health Dynamics Among the Oldest Old (AHEAD). AHEAD is a population-based household survey designed to examine the dynamic interactions between health, family, and economic variables among US older adults. Results showed that 33% of the older adults reported frequent pain and 20% reported significant pain resulting in activity limitation. Controlling for clinical health status, socio-demographic characteristics, and access to medical care, logistic regression analyses showed that those who often have pain were more than twice as likely (odds ratio (OR)=2.63; confidence interval (CI)=2.35, 2.95; P=<0.0001) to perceive their health status to be "poor". Other predictors (P<0.01) include functional impairment (OR=2.78), chronic diseases (OR=1.89), minority status (OR=1.88), education (OR=1.77), and physician visits (OR=1.64). This study documents the adverse impact of pain on self-rated health as well as the fact that the experience of pain and poor subjective health and well-being is greatest among the most socially disadvantaged older adults (minorities and those with the least education). The findings suggest that treating and controlling pain may significantly enhance the subjective health and well-being of community-dwelling older adults.

Arthritis onset and worsening self-rated health: A longitudinal evaluation of the role of pain and activity limitations

“…More recently, interest in understanding the determinants of SRH has increased. Predictors of good SRH include younger age (15)(16)(17), male sex (15), higher socioeconomic status (15,16,18), social support (19,20), and absence of chronic conditions and pain (15)(16)(17)(21)(22)(23). Although physiologic and psychological determinants of good SRH have been documented, the main determinant appears to be physical health (15,24,25).…”

“…The most significant predictor of poor SRH is the presence of chronic conditions (15,17,21,22,26). However, population-based and clinical studies indicate that 30 -80% of persons with at least 1 chronic condition report good health (15)(16)(17).…”

“…However, population-based and clinical studies indicate that 30 -80% of persons with at least 1 chronic condition report good health (15)(16)(17). This raises questions about the distinction between individuals' perceptions of their health status and a diagnosed medical condition.…”

“…It has been suggested that some individuals think about specific health problems when asked to rate their health, whereas others think in terms of general physical functioning or health behaviors (27). Pain is a common reason for seeking medical care around the world (28 -30), and is associated with poor SRH (15)(16)(17)23). Studies indicate that chronic pain seems to relate to poor health more strongly than chronic diseases or age, and the significant association persists even when sociodemographic and relevant health factors are considered (16,17).…”

“…Pain is a common reason for seeking medical care around the world (28 -30), and is associated with poor SRH (15)(16)(17)23). Studies indicate that chronic pain seems to relate to poor health more strongly than chronic diseases or age, and the significant association persists even when sociodemographic and relevant health factors are considered (16,17). One possible explanation is that pain is a mediator between chronic conditions and SRH.…”