Musculoskeletal pain and physical functioning in the oldest old

Authors

  • M. Mänty,

    Corresponding author
    1. Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark
    2. Center for Healthy Aging, University of Copenhagen, Denmark
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  • M. Thinggaard,

    1. The Danish Aging Research Centre, Universities of Copenhagen, Odense and Aarhus, Denmark
    2. Unit of Epidemiology, The Danish Twin Registry, University of Southern Denmark, Odense, Denmark
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  • K. Christensen,

    1. The Danish Aging Research Centre, Universities of Copenhagen, Odense and Aarhus, Denmark
    2. Unit of Epidemiology, The Danish Twin Registry, University of Southern Denmark, Odense, Denmark
    3. Department of Clinical Genetics, Odense University Hospital, Denmark
    4. Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Denmark
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  • K. Avlund

    1. Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark
    2. Center for Healthy Aging, University of Copenhagen, Denmark
    3. The Danish Aging Research Centre, Universities of Copenhagen, Odense and Aarhus, Denmark
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  • Funding sources

    This work was supported by the Nordea-Foundation, National Institute on Aging (Grant No. P01 AG08761) and by The Danish National Research Foundation. The Danish Aging Research Center is supported by a grant from the VELUX Foundation.

  • Conflicts of interest

    None declared.

Abstract

Background

Little is known about the impact of pain on physical functioning among the oldest-old subjects. In this study, we first examined the associations between the number of painful sites and measures of physical functioning reflecting different stages of the disablement process (physical impairment, functional limitation and disability) among nonagenarians (more than ninety years old persons). Second, we described the effect of painful sites on disability during a 2-year follow-up period.

Methods

This study is based on baseline (n = 1177) and 2-year follow-up (n = 709) data of the nationwide Danish 1905 cohort study. Musculoskeletal pain was assessed as reported pain in back, hips or knees when moving or resting. Physical performance measures included maximum grip strength and habitual walking speed. Disability in performing activities of daily living was defined as the need for assistive device or personal help in transferring, dressing, washing, using toilet and/or walking indoors.

Results

At baseline, the number of painful sites was significantly associated with measured grip strength and walking speed as well as self-reported disability in a stepwise manner; the more sites with pain, the poorer the physical functioning. The follow-up analyses showed corresponding but slightly weaker stepwise associations between baseline pain and disability level at follow-up, and indicated that although on the whole, single or multi-site pain did not predict the onset of disability, multi-site pain increased the risk of developing severe disability.

Conclusions

The findings of this study suggest that musculoskeletal pain in nonagenarians is highly prevalent and is associated with poor physical performance and disability.

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