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Pain and mortality: mechanisms for a relationship

Pain and mortality: mechanisms for a relationship
Pain and mortality: mechanisms for a relationship
Moderate to severe chronic pain affects 1 in 5 adults and its impact increases with age. People with chronic pain that interferes with their lives have an increased risk of mortality. Identifying how interfering chronic pain can lead to mortality may highlight potential intervention strategies. This study uses a novel approach to test whether lifestyle, health, social, and psychological factors mediate the relationship between pain and mortality. Survival analyses (Cox's proportional hazard modelling and a technique to assess mediation within survival models) were conducted on a large population study of adults aged 50 years or older from the English Longitudinal Study of Ageing (n = 6324). Data collected at wave 2 (2004) were used as baseline and follow-up was until 2012. The relationship between being “often troubled with pain” and mortality was examined. Lifestyle, health, social, and psychological factors were tested as potential mediators. The strongest mediating factors for the relationship between troubling pain and mortality were functional limitation (hazard ratio 1.31; 95% confidence interval 1.20-1.39), symptoms preventing walking quarter of a mile (1.45 [1.35–1.58]), physical inactivity (1.14 [1.10-1.20]), and poor self-rated health (1.32 [1.23-1.41]). Mediators of the relationship between troubling pain and mortality provide targets for preventive health programmes. Interventions to improve general health, activity, and function could improve long-term survival in patients with this clinical problem.
0304-3959
1112-1118
Smith, Diane
04f9642c-9ee2-4dc1-8203-5d975e798ec3
Wilkie, Ross
d8123db0-1990-4e6b-b7e6-29c4397cdb42
Croft, Peter
8faa5d3f-d4d6-4b68-b7fa-b4b284768b41
Parmar, Simran
546d69e6-ba57-4cea-9f48-f64f07424667
McBeth, John
98012716-66ba-480b-9e43-ac53b51dce61
Smith, Diane
04f9642c-9ee2-4dc1-8203-5d975e798ec3
Wilkie, Ross
d8123db0-1990-4e6b-b7e6-29c4397cdb42
Croft, Peter
8faa5d3f-d4d6-4b68-b7fa-b4b284768b41
Parmar, Simran
546d69e6-ba57-4cea-9f48-f64f07424667
McBeth, John
98012716-66ba-480b-9e43-ac53b51dce61

Smith, Diane, Wilkie, Ross, Croft, Peter, Parmar, Simran and McBeth, John (2018) Pain and mortality: mechanisms for a relationship. Pain, 159 (6), 1112-1118. (doi:10.1097/j.pain.0000000000001193).

Record type: Article

Abstract

Moderate to severe chronic pain affects 1 in 5 adults and its impact increases with age. People with chronic pain that interferes with their lives have an increased risk of mortality. Identifying how interfering chronic pain can lead to mortality may highlight potential intervention strategies. This study uses a novel approach to test whether lifestyle, health, social, and psychological factors mediate the relationship between pain and mortality. Survival analyses (Cox's proportional hazard modelling and a technique to assess mediation within survival models) were conducted on a large population study of adults aged 50 years or older from the English Longitudinal Study of Ageing (n = 6324). Data collected at wave 2 (2004) were used as baseline and follow-up was until 2012. The relationship between being “often troubled with pain” and mortality was examined. Lifestyle, health, social, and psychological factors were tested as potential mediators. The strongest mediating factors for the relationship between troubling pain and mortality were functional limitation (hazard ratio 1.31; 95% confidence interval 1.20-1.39), symptoms preventing walking quarter of a mile (1.45 [1.35–1.58]), physical inactivity (1.14 [1.10-1.20]), and poor self-rated health (1.32 [1.23-1.41]). Mediators of the relationship between troubling pain and mortality provide targets for preventive health programmes. Interventions to improve general health, activity, and function could improve long-term survival in patients with this clinical problem.

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More information

Published date: June 2018

Identifiers

Local EPrints ID: 491157
URI: http://eprints.soton.ac.uk/id/eprint/491157
ISSN: 0304-3959
PURE UUID: 1cbf6a61-9be2-42e7-a4d3-cedb92e8ff6f
ORCID for John McBeth: ORCID iD orcid.org/0000-0001-7047-2183

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Date deposited: 13 Jun 2024 16:56
Last modified: 25 Jun 2024 02:10

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Contributors

Author: Diane Smith
Author: Ross Wilkie
Author: Peter Croft
Author: Simran Parmar
Author: John McBeth ORCID iD

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