Relationship Between Persistent Pain and 5-Year Mortality: A Population-Based Prospective Cohort Study
Version of Record online: 9 DEC 2013
© 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 61, Issue 12, pages 2135–2141, December 2013
How to Cite
J Am Geriatr Soc 61:2135–2141, 2013.
- Issue online: 12 DEC 2013
- Version of Record online: 9 DEC 2013
- National Health Research Development Program. Grant Number: 6606–3954-MCS
- National Institute on Aging. Grant Number: K23AG029815
- Canadian Institutes of Health Research. Grant Number: MOP-62823
- National Institute of Diabetes and Digestive and Kidney Diseases Midcareer Investigator Award in Patient-Oriented Research. Grant Number: K24 DK071933
- Chicago Center for Diabetes Translation Research. Grant Number: P30 DK092949
- older adult
To assess the association between self-reported noncancer pain and 5-year mortality.
Community-dwelling older adults.
Canadian Study of Health and Aging 1996 wave.
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.
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.
Older women with pain were less likely to die within 5 years than older women without pain, men in pain, or men without pain.