Differences in Pain Characteristics and Functional Associations between Nursing Home Residents and Community-Dwelling Older Adults: A Cross-Sectional Study

Melis Tansuğ, Turhan Kahraman, Arzu Genç, Melis Tansuğ, Turhan Kahraman, Arzu Genç

Abstract

Background: Pain is one of the most critical issues in older adults, and the place of residence may play an important role in pain characteristics and related factors. However, it is an understudied subject. This study investigated differences in pain characteristics and functional associations between nursing home residents and community-dwelling older adults.

Methods: Older adult participants were recruited from nursing homes (n=73) and the community (n=73). Pain characteristics, including type, intensity, and number of pain sites, were evaluated. Other outcome measures were functional mobility, walking speed, functional independence, physical activity, anxiety, depression, and health-related quality of life.

Results: Nursing home residents experienced musculoskeletal pain more frequently and had a greater number of pain sites than community-dwelling older adults (p<0.05). Walking speed and mobility were significantly lower and anxiety and depression were significantly higher in nursing home residents (p<0.05). While higher pain intensity was significantly correlated with low scores on physical measures, low health-related quality of life, and higher depression and anxiety symptoms in both groups (p<0.05), the magnitudes of the correlations were much higher in nursing home residents. The number of pain sites was significantly correlated with low scores on physical measures, low health-related quality of life, and higher depression and anxiety symptoms mainly in nursing home residents (p<0.05).

Conclusion: Compared to community-dwelling older adults, nursing home residents experienced musculoskeletal pain more frequently and at more sites in the body. Higher pain intensity and number of pain sites were associated with worse clinical variables, mainly in nursing home residents. This study highlights the importance of regular pain assessment, especially in nursing home care settings.

Keywords: Aged; Health impact assessment; Nursing homes; Pain; Residence characteristics.

Conflict of interest statement

CONFLICT OF INTEREST

The researchers claim no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Distribution of pain sites according to the place of residence in the last year (A) and week (B) in people with musculoskeletal pain (n=66). Values are presented as percent. *Statistically significant difference.
Fig. 2.
Fig. 2.
Distribution of pain sites according to the place of residence in the last year (A) and week (B) in people with neuropathic pain (n=80). Values are presented as percent. *Statistically significant difference.
Fig. 3.
Fig. 3.
Distribution of pain sites according to the place of residence in the last year (A) and week (B) in the whole sample (n=146). Values are presented as percent. *Statistically significant difference.

References

    1. Xu Y, Jiang N, Wang Y, Zhang Q, Chen L, Ma S. Pain perception of older adults in nursing home and home care settings: evidence from China. BMC Geriatr. 2018;18:152.
    1. Beissner K, Bach E, Murtaugh C, Parker SJ, Trachtenberg M, Reid MC. Implementing a cognitive-behavioral pain self-management program in home health care, part 1: program adaptation. J Geriatr Phys Ther. 2013;36:123–9.
    1. AGS Panel on Persistent Pain in Older Persons The management of persistent pain in older persons. J Am Geriatr Soc. 2002;50(6 Suppl):S205–24.
    1. McDermott AM, Toelle TR, Rowbotham DJ, Schaefer CP, Dukes EM. The burden of neuropathic pain: results from a cross-sectional survey. Eur J Pain. 2006;10:127–35.
    1. Stompor M, Grodzicki T, Stompor T, Wordliczek J, Dubiel M, Kurowska I. Prevalence of chronic pain, particularly with neuropathic component, and its effect on overall functioning of elderly patients. Med Sci Monit. 2019;25:2695–701.
    1. Podichetty VK, Mazanec DJ, Biscup RS. Chronic non-malignant musculoskeletal pain in older adults: clinical issues and opioid intervention. Postgrad Med J. 2003;79:627–33.
    1. Galluzzi KE. Managing neuropathic pain. J Am Osteopath Assoc. 2007;107(10 Suppl 6):ES39–48.
    1. Keskinoglu P, Ucku R, Yener G, Yaka E, Kurt P, Tunca Z. Reliability and validity of revised Turkish version of Mini Mental State Examination (rMMSE-T) in community-dwelling educated and uneducated elderly. Int J Geriatr Psychiatry. 2009;24:1242–50.
    1. Fox PL, Raina P, Jadad AR. Prevalence and treatment of pain in older adults in nursing homes and other long-term care institutions: a systematic review. CMAJ. 1999;160:329–33.
    1. Freynhagen R, Baron R, Gockel U, Tolle TR. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin. 2006;22:1911–20.
    1. Alkan H, Ardic F, Erdogan C, Sahin F, Sarsan A, Findikoglu G. Turkish version of the painDETECT questionnaire in the assessment of neuropathic pain: a validity and reliability study. Pain Med. 2013;14:1933–43.
    1. Kahraman T, Genc A, Goz E. The Nordic Musculoskeletal Questionnaire: cross-cultural adaptation into Turkish assessing its psychometric properties. Disabil Rehabil. 2016;38:2153–60.
    1. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18:233–7.
    1. Yim-Chiplis PK, Talbot LA. Defining and measuring balance in adults. Biol Res Nurs. 2000;1:321–31.
    1. Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther. 2002;82:128–37.
    1. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–8.
    1. Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing. 1997;26:15–9.
    1. Peters DM, Fritz SL, Krotish DE. Assessing the reliability and validity of a shorter walk test compared with the 10-Meter Walk Test for measurements of gait speed in healthy, older adults. J Geriatr Phys Ther. 2013;36:24–30.
    1. Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol. 1989;42:703–9.
    1. Topolski TD, LoGerfo J, Patrick DL, Williams B, Walwick J, Patrick MB. The Rapid Assessment of Physical Activity (RAPA) among older adults. Prev Chronic Dis. 2006;3:A118.
    1. Cekok FK, Kahraman T, Kalkisim M, Genc A, Keskinoglu P. Cross-cultural adaptation and psychometric study of the Turkish version of the Rapid Assessment of Physical Activity. Geriatr Gerontol Int. 2017;17:1837–42.
    1. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.
    1. Djukanovic I, Carlsson J, Arestedt K. Is the Hospital Anxiety and Depression Scale (HADS) a valid measure in a general population 65-80 years old? A psychometric evaluation study. Health Qual Life Outcomes. 2017;15:193.
    1. Aydemir O, Guvenir T, Kuey L, Kultur S. Validity and reliability of Turkish version of hospital anxiety and depression scale. Turk Psikiyatri Derg. 1997;8:280–7.
    1. Ware JE, Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–83.
    1. Haywood KL, Garratt AM, Fitzpatrick R. Quality of life in older people: a structured review of generic self-assessed health instruments. Qual Life Res. 2005;14:1651–68.
    1. Kocyigit H, Aydemir O, Fisek G, Olmez N, Memis A. Kısa Form 36 (KF-36)’nın Türkçe versiyonunun güvenilirliği ve geçerliliği [Reliability and Validity of the Turkish Version of Short Form-36 (SF-36)] Ilac ve Tedavi Dergisi. 1999;12:102–6.
    1. Cohen J. Statistical power analysis for the behavioral sciences. Hoboken, NJ: Taylor and Francis; 2013.
    1. Kutsal YG, Eyigor S, Dogan A, Zardaut S, Durmus B, Evcik FD, et al. Neuropathic pain in elderly: a multicenter study. Turk J Geriatr. 2016;19:9–18.
    1. Salman Roghani R, Delbari A, Asadi-Lari M, Rashedi V, Lokk J. Neuropathic pain prevalence of older adults in an urban area of Iran: a population-based study. Pain Res Treat. 2019;2019:9015695.
    1. Vasconcelos Rocha S, Souza Dos Santos S, Carneiro Vasconcelos LR, Alves Dos Santos C. Strength and ability to implement the activities of daily living in elderly resident in rural areas. Colomb Med (Cali) 2016;47:167–71.
    1. Kahraman T, Cekok FK, Ugut BO, Keskinoglu P, Genc A. One-year change in the physical functioning of older people according to the international classification of functioning domains. J Geriatr Phys Ther. 2021;44:E9–E17.
    1. Leveille SG, Jones RN, Kiely DK, Hausdorff JM, Shmerling RH, Guralnik JM, et al. Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA. 2009;302:2214–21.
    1. Shah RC, Buchman AS, Boyle PA, Leurgans SE, Wilson RS, Andersson GB, et al. Musculoskeletal pain is associated with incident mobility disability in community-dwelling elders. J Gerontol A Biol Sci Med Sci. 2011;66:82–8.
    1. Manty M, Thinggaard M, Christensen K, Avlund K. Musculoskeletal pain and physical functioning in the oldest old. Eur J Pain. 2014;18:522–9.
    1. Eggermont LH, Leveille SG, Shi L, Kiely DK, Shmerling RH, Jones RN, et al. Pain characteristics associated with the onset of disability in older adults: the maintenance of balance, independent living, intellect, and zest in the Elderly Boston Study. J Am Geriatr Soc. 2014;62:1007–16.
    1. Jakobsson U, Klevsgard R, Westergren A, Hallberg IR. Old people in pain: a comparative study. J Pain Symptom Manage. 2003;26:625–36.
    1. Nakai Y, Makizako H, Kiyama R, Tomioka K, Taniguchi Y, Kubozono T, et al. Association between chronic pain and physical frailty in community-dwelling older adults. Int J Environ Res Public Health. 2019;16:1330.
    1. Schofield P. Pain in older adults: epidemiology, impact and barriers to management. Rev Pain. 2007;1:12–4.
    1. Miu DK, Chan KC. Under-detection of pain in elderly nursing home residents with moderate to severe dementia. J Clin Gerontol Geriatr. 2014;5:23–7.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj