The Onset of Widespread Musculoskeletal Pain Is Associated with a Decrease in Healthy Ageing in Older People: A Population-Based Prospective Study

Abstract

ObjectiveChronic musculoskeletal pain is common in older adults but the nature of its relationship with ageing is unclear. The objective for this study was to test the hypothesis that the onset of widespread pain would be associated with a decrease in healthy ageing.MethodsPopulation-based prospective cohort study. A “healthy ageing” index was constructed across biomedical, physical, psychosocial and lay components. Analysis was performed with 2949 adults aged 50 years and over who had complete index scores at baseline, 3 and 6-year follow-ups.ResultsAt three and six year follow-up, 365 (16.8%) and 259 (14.3%) experienced the onset of widespread pain. The onset of widespread pain during the six-year period was associated with a 25% and a 46% decrease in healthy ageing index scores; this decrease was independent of age, sex, education, social networks, smoking status, alcohol consumption and physical inactivity. The decrease in healthy ageing attenuated to 20% and 39% following adjustment for diagnosed musculoskeletal conditions and analgesic and non-steroidal use.ConclusionsThe onset of widespread pain was associated with a decrease in healthy ageing throughout the six-year period. When pain increased over time, the markers of unhealthy ageing increased also. Strong analgesia was associated with unhealthy ageing. Research could now usefully test whether early identification, improved treatment and prevention of pain prior to old age may facilitate healthy ageing.

Allostatic load and pain severity in older adults: Results from the English Longitudinal Study of Ageing

“…As such it activates the stress response systems, and may contribute to an increased AL [6, 23, 47]. Consistent with the AL model, pain portends increased morbidity and mortality [2, 9, 29, 33, 61, 62]. Altered immune, endocrine, and cardiovascular functioning has been demonstrated in individuals with persistent pain [15, 27, 43, 46].…”

Older adults’ preferences for formal social support of autonomy and dependence in pain: development and validation of a scale

“…Considering current epidemiological data on pain and ageing, over half of older adults will likely suffer from chronic (musculoskeletal) pain (Gibson 2007;Helme and Gibson 2001;Molton and Terrill 2014;Yamada and Thomas 2011), i.e., pain that persists beyond a "conventional" tissue healing time -3 months (Merskey and Bogduk 1994). Chronic pain is often highly disabling (Reyes-Gibby, Aday and Cleeland 2002;Ferrel et al 1995;Helme and Gibson 1997) and one of the main obstacles to older adults' ability to perform physical, cognitive and social activities independently -functional autonomy (Hébert et al 2001;Sttubs et al, 2013) -and to an healthy ageing process (Wilkie et al 2013). In other words, population ageing will most likely result in an increased prevalence of disabling chronic pain at the population level.…”

Resilience moderates the association between chronic pain and depressive symptoms in the elderly

“…Compared with individuals with chronic local pain (CLP), those suffering from CWP have more persistent pain, increased psychiatric symptom burden and fatigue and apply more often for disability pension (Nordeman et al, 2012;Viniol et al, 2013). In the elderly, CWP is associated more strongly than CLP with progression of disability (Leveille et al, 2001), depressed mood (Denkinger et al, 2014) and decreases in functioning and social participation (Wilkie et al, 2013).…”