Pain reporting in older adults: The influence of cognitive impairment - Results from the Cambridge city >75 cohort study

Rachael E. Docking, Jane Fleming, Carol Brayne, Jun Zhao, Gary J. Macfarlane, Gareth T. Jones*

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: Evidence suggests that while disabling back pain (BP), and rheumatic diseases associated with pain, continues to increase with age, the prevalence of non-disabling BP reaches a plateau, or even decreases, in the oldest old. This study aimed to determine whether this age-related pattern of nondisabling BP is a function of increasing cognitive impairment. Methods: Cross-sectional study of adults aged >77 years. Participants answered interviewer-administered questions on BP and cognitive function, assessed using the Mini-Mental State Examination, categorised into normal versus mild, moderate or severe impairment. The relationship between cognitive function and BP was examined using multinomial logistic regression, adjusted for age, sex and residence. Results: Of 1174 participants with BP data, 1126 (96%) completed cognitive assessments. The relation- ship between cognitive function and BP differed for disabling and non-disabling BP. Across categories of cognitive impairment, increasingly higher prevalence of disabling BP was reported, compared to those with normal cognition, although this was not statistically significant (odds ratio (OR) = 1.7; 95% confi- dence interval (CI) = 0.7-4.6). No association was found between cognitive function and non-disabling BP (OR = 0.8; 95% CI = 0.4-1.6). Conclusion: This study found no association between the reporting of BP and level of cognitive impairment, suggesting that increasing cognitive impairment is an inadequate explanation for age-related decline in self-reported non-disabling BP. Future research should determine the reasons for the decline in non-disabling pain in older adults, although, meanwhile, it is important to ensure that this group receive appropriate pain assessment and pain management.

Original languageEnglish
Pages (from-to)119-124
Number of pages6
JournalBritish Journal of Pain
Volume8
Issue number3
DOIs
Publication statusPublished - 1 Aug 2014

Fingerprint

Back Pain
Cohort Studies
Pain
Cognition
Cognitive Dysfunction
Odds Ratio
Confidence Intervals
Ships
Pain Measurement
Pain Management
Rheumatic Diseases
Cross-Sectional Studies
Logistic Models
Interviews

Keywords

  • Back pain
  • Cognitive impairment
  • Dementia
  • Older people

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Pain reporting in older adults : The influence of cognitive impairment - Results from the Cambridge city >75 cohort study. / Docking, Rachael E.; Fleming, Jane; Brayne, Carol; Zhao, Jun; Macfarlane, Gary J.; Jones, Gareth T.

In: British Journal of Pain, Vol. 8, No. 3, 01.08.2014, p. 119-124.

Research output: Contribution to journalArticle

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abstract = "Objectives: Evidence suggests that while disabling back pain (BP), and rheumatic diseases associated with pain, continues to increase with age, the prevalence of non-disabling BP reaches a plateau, or even decreases, in the oldest old. This study aimed to determine whether this age-related pattern of nondisabling BP is a function of increasing cognitive impairment. Methods: Cross-sectional study of adults aged >77 years. Participants answered interviewer-administered questions on BP and cognitive function, assessed using the Mini-Mental State Examination, categorised into normal versus mild, moderate or severe impairment. The relationship between cognitive function and BP was examined using multinomial logistic regression, adjusted for age, sex and residence. Results: Of 1174 participants with BP data, 1126 (96{\%}) completed cognitive assessments. The relation- ship between cognitive function and BP differed for disabling and non-disabling BP. Across categories of cognitive impairment, increasingly higher prevalence of disabling BP was reported, compared to those with normal cognition, although this was not statistically significant (odds ratio (OR) = 1.7; 95{\%} confi- dence interval (CI) = 0.7-4.6). No association was found between cognitive function and non-disabling BP (OR = 0.8; 95{\%} CI = 0.4-1.6). Conclusion: This study found no association between the reporting of BP and level of cognitive impairment, suggesting that increasing cognitive impairment is an inadequate explanation for age-related decline in self-reported non-disabling BP. Future research should determine the reasons for the decline in non-disabling pain in older adults, although, meanwhile, it is important to ensure that this group receive appropriate pain assessment and pain management.",
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