<p>Lifestyle Aspects As A Predictor Of Pain Among Oldest-Old Primary Care Patients – A Longitudinal Cohort Study</p>

Abstract

PurposeDealing with the high prevalence of pain among the oldest-old (+75) is becoming a major health issue. Therefore, the aim of the study was to uncover health-related lifestyle behaviors (HLB) and age-related comorbidities which may predict, influence and prevent pain in old age.Patients and methodsIn this longitudinal cohort study, data were obtained initially from 3.327 individuals aged 75+ from over 138 general practitioners (GP) during structured clinical interviews in 2003. Nine follow-ups (FU) were assessed until 2017. Available data from 736 individuals scoring in FU3 and FU7 were included in this analysis. Data were assembled in an ambulatory setting at participant’s homes. Associations were tested using a linear regression model (model 1) and ordered logistic regression model (model 2).ResultsStatistical analyses revealed increased likelihood to experience pain for participants with comorbidities such as peripheral arterial disease (PAD) (coef. 13.51, P>t = 0.00) or chronic back pain (CBP) (coef. 6.64, P>t = 0.003) or higher body mass index (BMI) (coef. 0.57, P>t = 0.015) and, female gender (coef. 6.00, SE 3.0, t = 2.02, P>t = 0.044). Participants with medium education and former smokers showed significantly lower pain rating (coef. −5.05, P>t = 0.026; coef. −5.27, P>t = 0.026). Suffering from chronic back pain (OR = 2.03), osteoarthritis (OR = 1.49) or depressive symptoms (OR = 1.10) raised the odds to experience impairments in daily living due to pain. Physical activity showed no significant results.ConclusionChronic conditions such as PAD, or CBP, female gender and higher BMI may increase the risk of experiencing more pain while successful smoking cessation can lower pain ratings at old age. Early and consistent support through GPs should be given to older patients in order to prevent pain at old age.

Chronic Pain in the Elderly: Mechanisms and Perspectives

“…Another study proposed that both, an older age, and the presence of at least one comorbidity, were predicting factors for chronic musculoskeletal pain in elders ( Kirubakaran and Dongre, 2019 ). An interesting longitudinal cohort analysis, carried out with oldest-old individuals (>75-year-old), suggested that peripheral arterial disease, low back pain, high BMI, and female sex are associated with a higher risk of pain experience at old ages, whereas smoking cessation might account for a reduction of pain syndromes in seniors ( Mallon et al, 2019 ). As reviewed by Domenichiello and Ramsden (2019) , aging can be considered as a risk factor for chronic pain, being a primary cause of disability or a consequence of other diseases commonly seen in geriatric patients.…”