Persistence and Remission of Musculoskeletal Pain in Community-Dwelling Older Adults: Results from the Cardiovascular Health Study

Authors

  • Stephen M. Thielke MD, MSPH,

    Corresponding author
    1. Geriatric Research, Education, and Clinical Center, Puget Sound Veterans Affairs Medical Center, Seattle, Washington
    • Departments of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
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  • Heather Whitson MD, MHS,

    1. Department of Medicine (Geriatrics) and the Aging Center, Duke University Medical Center, Durham, North Carolina
    2. Geriatric Research, Education, and Clinical Center, Durham VA Medical Center, Durham, North Carolina
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  • Paula Diehr PhD,

    1. Biostatistics, University of Washington, Seattle, Washington
    2. Health Services, University of Washington, Seattle, Washington
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  • Ann O'Hare MD, MA,

    1. Division of Nephrology, University of Washington, Seattle, Washington
    2. Department of Hospital and Speciality Medicine, Veterans Affairs Puget Sound Health Care System and Group Health Research Institute, Seattle, Washington
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  • Patricia M. Kearney PhD,

    1. Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
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  • Sarwat I. Chaudhry MD,

    1. Department of Internal Medicine, Yale University, New Haven, Connecticut
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  • Neil A. Zakai MD, MSc,

    1. Departments of Medicine, College of Medicine, University of Vermont, Burlington, Vermont
    2. Pathology, College of Medicine, University of Vermont, Burlington, Vermont
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  • Dae Kim MD, MPH,

    1. Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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  • Nishant Sekaran MD,

    1. Division of General Internal Medicine, University of Michigan, Ann Arbor, Michigan
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  • Joanna E. M. Sale PhD,

    1. Mobility Program Clinical Research Unit, Li KaShing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
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  • Alice M. Arnold PhD,

    1. Biostatistics, University of Washington, Seattle, Washington
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  • Paulo Chaves MD, PhD,

    1. Mobility Program Clinical Research Unit, Li KaShing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
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  • Anne Newman MD, MPH

    1. Benjamin Leon Jr. Family Center for Geriatric Research and Education, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
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Address correspondence to Stephen Thielke, Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195.

E-mail sthielke@u.washington.edu

Abstract

Objectives

To characterize longitudinal patterns of musculoskeletal pain in a community sample of older adults over a 6-year period and to identify factors associated with persistence of pain.

Design

Secondary analysis of the Cardiovascular Health Study.

Setting

Community-based cohort drawn from four U.S. counties.

Participants

Five thousand ninety-three men and women aged 65 and older.

Measurements

Over a 6-year period, pain was assessed each year using a single question about the presence of pain in any bones or joints during the last year. If affirmative, participants were queried about pain in seven locations (hands, shoulders, neck, back, hips, knees, feet). Participants were categorized according to the percentage of time that pain was present and according to the intermittent or chronic pattern of pain. Factors associated with persistent pain during five remaining years of the study were identified.

Results

Over 6 years, 32% of participants reported pain for three or more consecutive years, and 32% reported pain intermittently. Of those who reported pain the first year, 54% were pain free at least once during the follow-up period. Most of the pain at specific body locations was intermittent. Factors associated with remission of pain over 5 years included older age, male sex, better self-rated health, not being obese, taking fewer medications, and having fewer depressive symptoms. Approximately half of those with pain reported fewer pain locations the following year.

Conclusion

Musculoskeletal pain in older adults, despite high prevalence, is often intermittent. The findings refute the notion that pain is an inevitable, unremitting, or progressive consequence of aging.

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