Clustering of pain and its associations with health in people aged 50 years and older: cross-sectional results from the North Staffordshire Osteoarthritis Project
Clustering of pain and its associations with health in people aged 50 years and older: cross-sectional results from the North Staffordshire Osteoarthritis Project
Objective: most pain in patients aged ≥50 years affects multiple sites and yet the predominant mode of presentation is single-site syndromes. The aim of this study was to investigate if pain sites form clusters in this population and if any such clusters are associated with health factors other than pain.
Setting: six general practices in North Staffordshire, UK.
Design: cross-sectional, postal questionnaire, study.
Participants: community-dwelling adults aged ≥50 years registered at the general practices.
Main outcomes measures: number of pain sites was measured by asking participants to shade sites of pain lasting ≥1 day in the past 4 weeks on a blank body manikin. Health factors measured included anxiety and depression (Hospital and Anxiety Depression Scale), cognitive complaint (Sickness Impact Profile) and sleep. Pain site clustering was investigated using latent class analysis. Association of clusters with health factors, adjusted for age, sex, body mass index and morbidities, was analysed using multinomial regression models.
Results: 13 986 participants (adjusted response 70.6%) completed a questionnaire, of whom 12 408 provided complete pain data. Four clusters of participants were identified: (1) low number of pain sites (36.6%), (2) medium number of sites with no back pain (31.5%), (3) medium number of sites with back pain (17.9%) and (4) high number of sites (14.1%). Compared to Cluster 1, other clusters were associated with poor health. The strongest associations (relative risk ratios, 95% CI) were with Cluster 4: depression (per unit change in score) 1.11 (1.08 to 1.14); cognitive complaint 2.60 (2.09 to 3.24); non-restorative sleep 4.60 (3.50 to 6.05).
Conclusions: these results indicate that in a general population aged ≥50 years, pain forms four clusters shaped by two dimensions—number of pain sites (low, medium, high) and, within the medium cluster, the absence or presence of back pain. The usefulness of primary care treatment approaches based on this simple classification should be investigated.
Lacey, R.J.
6a5ba7da-7730-4e36-9448-7291d24f9809
Strauss, V.Y.
7b86a616-838e-4bf1-b96a-8bf644ed754a
Rathod, T.
cbe7a160-235c-4484-89e7-25728f923117
Belcher, J
1103137a-085e-4f85-9323-740ca462d6df
Croft, P.R.
eadc2149-f0c1-41c4-9a64-bb7229e16af7
Natvig, B.
e5153f77-0bee-4663-a10d-b29d825aabbe
Wilkie, R.
6f938273-5b6d-4677-80e3-56d244ce0399
McBeth, J.
98012716-66ba-480b-9e43-ac53b51dce61
9 November 2015
Lacey, R.J.
6a5ba7da-7730-4e36-9448-7291d24f9809
Strauss, V.Y.
7b86a616-838e-4bf1-b96a-8bf644ed754a
Rathod, T.
cbe7a160-235c-4484-89e7-25728f923117
Belcher, J
1103137a-085e-4f85-9323-740ca462d6df
Croft, P.R.
eadc2149-f0c1-41c4-9a64-bb7229e16af7
Natvig, B.
e5153f77-0bee-4663-a10d-b29d825aabbe
Wilkie, R.
6f938273-5b6d-4677-80e3-56d244ce0399
McBeth, J.
98012716-66ba-480b-9e43-ac53b51dce61
Lacey, R.J., Strauss, V.Y., Rathod, T., Belcher, J, Croft, P.R., Natvig, B., Wilkie, R. and McBeth, J.
(2015)
Clustering of pain and its associations with health in people aged 50 years and older: cross-sectional results from the North Staffordshire Osteoarthritis Project.
BMJ Open, 5, [e008389].
(doi:10.1136/bmjopen-2015-008389).
Abstract
Objective: most pain in patients aged ≥50 years affects multiple sites and yet the predominant mode of presentation is single-site syndromes. The aim of this study was to investigate if pain sites form clusters in this population and if any such clusters are associated with health factors other than pain.
Setting: six general practices in North Staffordshire, UK.
Design: cross-sectional, postal questionnaire, study.
Participants: community-dwelling adults aged ≥50 years registered at the general practices.
Main outcomes measures: number of pain sites was measured by asking participants to shade sites of pain lasting ≥1 day in the past 4 weeks on a blank body manikin. Health factors measured included anxiety and depression (Hospital and Anxiety Depression Scale), cognitive complaint (Sickness Impact Profile) and sleep. Pain site clustering was investigated using latent class analysis. Association of clusters with health factors, adjusted for age, sex, body mass index and morbidities, was analysed using multinomial regression models.
Results: 13 986 participants (adjusted response 70.6%) completed a questionnaire, of whom 12 408 provided complete pain data. Four clusters of participants were identified: (1) low number of pain sites (36.6%), (2) medium number of sites with no back pain (31.5%), (3) medium number of sites with back pain (17.9%) and (4) high number of sites (14.1%). Compared to Cluster 1, other clusters were associated with poor health. The strongest associations (relative risk ratios, 95% CI) were with Cluster 4: depression (per unit change in score) 1.11 (1.08 to 1.14); cognitive complaint 2.60 (2.09 to 3.24); non-restorative sleep 4.60 (3.50 to 6.05).
Conclusions: these results indicate that in a general population aged ≥50 years, pain forms four clusters shaped by two dimensions—number of pain sites (low, medium, high) and, within the medium cluster, the absence or presence of back pain. The usefulness of primary care treatment approaches based on this simple classification should be investigated.
Text
e008389.full
- Version of Record
More information
Accepted/In Press date: 17 August 2015
Published date: 9 November 2015
Identifiers
Local EPrints ID: 491445
URI: http://eprints.soton.ac.uk/id/eprint/491445
ISSN: 2044-6055
PURE UUID: a0ac97d0-1196-4d85-9df3-a9047f291f39
Catalogue record
Date deposited: 24 Jun 2024 16:47
Last modified: 25 Jun 2024 02:10
Export record
Altmetrics
Contributors
Author:
R.J. Lacey
Author:
V.Y. Strauss
Author:
T. Rathod
Author:
J Belcher
Author:
P.R. Croft
Author:
B. Natvig
Author:
R. Wilkie
Author:
J. McBeth
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics