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22-09-2013 | Geriatrics | Article

Musculoskeletal pain highly prevalent in oldest old

Abstract

Free abstract

medwireNews: Musculoskeletal pain affects more than half of people aged 90 years and older, a Danish cohort study has found.

The finding is significant because pain is associated with poor physical performance and disability, say Minna Mänty (University of Copenhagen, Denmark) and co-authors writing in the European Journal of Pain.

Using data from the Danish 1905 cohort study, Mänty’s group identified 1177 individuals who were aged 92 to 93 years at the time of the baseline survey, in 1998, and 709 individuals who were re-evaluated 2 years later.

Around two-thirds of participants were women and one-third lived in sheltered housing. At baseline, 52% of the cohort reported musculoskeletal pain: 32% had pain in one site, 14% in two, and 6% in three sites.

The number of painful sites positively correlated with the number of diseases, number of prescribed medications, and severity of depressive symptoms, report the study authors. Patient characteristics that predicted pain included female gender, living in sheltered housing, and being sedentary.

As the number of painful sites rose from zero to three, grip strength and walking speed both declined and the Activities of Daily Living disability score rose in a stepwise manner; all trends were statistically significant after adjusting for potential confounders.

Sixty percent of the original cohort was reassessed at the 2-year follow-up. Adjusted analysis of this subset revealed an association between musculoskeletal pain at baseline and disability at follow-up, such that a higher number of painful sites predicted higher future levels of disability.

For instance, participants with multisite pain at baseline were 1.5 times more likely to have at least moderate disability and 2.0 times more likely to have severe disability at follow-up, compared with participants with no pain.

Further longitudinal analyses indicated that while pain per se did not predict the onset of disability, multisite pain increased the risk for developing severe disability 1.3-fold.

“It is possible that due to high susceptibility to functional decline in the oldest-old population segment, multi-site pain may cause severe physical constraints that are likely to hinder multiple daily activities,” write Mänty et al.

They conclude: “[T]he results of this study, together with previous observations with younger older adults, suggest that the public health efforts to encourage lifestyle changes and interventions that would ameliorate pain might potentially increase the efficacy of efforts to decrease the burden of disabilities in the rapidly ageing population.”

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Joanna Lyford, Senior medwireNews Reporter

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