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Relationship Between Persistent Pain and 5‐Year Mortality: A Population‐Based Prospective Cohort Study
Author(s) -
Shega Joseph W.,
Andrew Melissa,
Kotwal Ashwin,
Lau Denys T.,
Herr Keela,
Ersek Mary,
Weiner Debra K.,
Chin Marshall H.,
Dale William
Publication year - 2013
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12554
Subject(s) - medicine , prospective cohort study , cohort study , population , gerontology , demography , pediatrics , environmental health , sociology
Objectives To assess the association between self‐reported noncancer pain and 5‐year mortality. Design Cohort. Setting Community‐dwelling older adults. Participants Canadian Study of Health and Aging 1996 wave. Measurements Registrar of Vital Statistics–established 5‐year mortality. Noncancer pain was assessed using the 5‐point verbal descriptor scale, dichotomized into no or very mild versus moderate, severe, or very severe pain. Frailty was the accumulation of health deficits. Cognitive status (Modified Mini‐Mental State Examination) and depressed mood (five‐item mental health screening questionnaire) were also assessed. Multivariable logistic regression and Cox proportional hazards were used to analyze the relationship between pain and 5‐year mortality. Results Of 5,703 participants, 4,694 (82.3%) had complete data for analysis; 1,663 of these (35.4%) reported moderate, severe, or very severe pain, and 1,343 (28.6%) had died at 5‐year follow‐up. Four hundred ninety‐six of those who died (29.8%) reported moderate, severe, or very severe pain and 847 (27.9%) no or very mild pain. Multivariate logistic analysis found that individuals with moderate, severe, or very severe pain had lower odds of 5‐year mortality than those with no or very mild pain (odds ratio = 0.78, 95% confidence interval (CI) = 0.66–0.92; P < .001). The risk of death was lower in persons reporting moderate or greater pain than in those with no or very mild pain (HR = 0.85, 95% CI = 0.75–0.96; P = .01). An interaction between pain and sex explained this effect. Men with pain were not significantly more likely than men without pain to die (HR = 1.00, 95% CI = 0.84–1.19; P = .99), whereas women without pain (HR = 0.54, 95% CI = 0.47–0.63; P < 0.01) and women with pain (HR = 0.40; CI = 0.33–0.47; P < .01) had less risk of death than men without and with pain, respectively. Conclusion Older women with pain were less likely to die within 5 years than older women without pain, men in pain, or men without pain.