Discuss various sites of pain
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Number of pain sites (NPS) is a potentially important marker of health-related quality of life (HRQoL) but remains unexplored in older people. This cross-sectional study investigated whether, in older people including the oldest old, NPS was independently associated with poorer mental and physical HRQoL and if the association was moderated by age.
Methods. A postal questionnaire sent to a population sample of adults aged ≥50 years in North Staffordshire, UK, included the 12-item Short Form Health Survey (SF-12) mental component summary (MCS) and physical component summary (PCS), a blank body pain manikin, socio-demographic, health behaviour and morbidity questions. Participants shaded sites of pain lasting ≥1 day in the past 4 weeks on the manikin. OA consultation data were obtained for participants consenting to medical records review.
Results. A total of 13 986 individuals (adjusted response 70.6%) completed a questionnaire, of which 12 408 provided complete pain data. The median NPS reported was 4 [interquartile range (IQR) 0–8]. General linear models showed that an increasing NPS was significantly associated with poorer MCS (β = −0.43, 95% CI −0.46, −0.40) and PCS (β = −0.87, 95% CI −0.90, −0.84). Adjustment for covariates attenuated the associations but they remained significant (MCS: β = −0.28, 95% CI −0.31, −0.24; PCS: β = −0.63, 95% CI −0.66, −0.59). The association between NPS and MCS or PCS was moderated by age, but the strongest associations were not in the oldest old.
Conclusion. NPS appears to be a potentially modifiable target for improving physical and mental HRQoL in older people. Future analyses should investigate the influence of NPS on HRQoL over time in older people.
Keywords: aged, cross-sectional survey, health-related quality of life, mental health, multisite pain, pain sites, physical health
Introduction
Musculoskeletal pain commonly occurs at multiple body sites in community-dwelling older adults, with 21–43% of persons aged ≥65 years reporting pain at two or more sites [1–3], with the variation possibly dependent on the number of pain sites (NPS) and chronicity of pain measured. The prevalence of multiple pain sites appears relatively stable over time [4] and similar across age groups [5], with studies of older people showing only a slight decline in the prevalence of multiple site pain after about age 75 years .
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Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain's widely used definition defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage"........
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