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Zimmer Z, Sun F, Duynisveld A. Are We Adding Pain-Free Years to Life? A Test of Compression Versus Expansion of Morbidity. J Gerontol A Biol Sci Med Sci 2024; 79:glae157. [PMID: 38878282 PMCID: PMC11253204 DOI: 10.1093/gerona/glae157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND There has been debate regarding whether increases in longevity result in longer and healthier lives or more disease and suffering. To address the issue, this study uses health expectancy methods and tests an expansion versus compression of morbidity with respect to pain. METHODS Data are from 1993 to 2018 Health and Retirement Study. Pain is categorized as no pain, nonlimiting, and limiting pain. Multistate life tables examine 77 996 wave-to-wave transitions across pain states or death using the Stochastic Population Analysis for Complex Events program. Results are presented as expected absolute and relative years of life for 70-, 80-, and 90-year-old men and women. Confidence intervals assess significance of differences over time. Population- and status-based results are presented. RESULTS For those 70 and 80 years old, relative and absolute life with nonlimiting and limiting pain increased substantially for men and women, and despite variability on a wave-to-wave basis, results generally confirm an expanding pain morbidity trend. Results do not vary by baseline status, indicating those already in pain are just as likely to experience expansion of morbidity as those pain-free at baseline. Results are different for 90-year-olds who have not experienced expanding pain morbidity and do not show an increase in life expectancy. CONCLUSIONS Findings are consistent with extant literature indicating increasing pain prevalence among older Americans and portend a need for attention to pain-coping resources, therapies, and prevention strategies.
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Affiliation(s)
- Zachary Zimmer
- Department of Family Studies & Gerontology and The Global Aging Research Initiative, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Feinuo Sun
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, USA
| | - Amber Duynisveld
- Department of Family Studies & Gerontology and The Global Aging Research Initiative, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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2
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Hebert SV, Green MA, Mashaw SA, Brouillette WD, Nguyen A, Dufrene K, Shelvan A, Patil S, Ahmadzadeh S, Shekoohi S, Kaye AD. Assessing Risk Factors and Comorbidities in the Treatment of Chronic Pain: A Narrative Review. Curr Pain Headache Rep 2024; 28:525-534. [PMID: 38558165 DOI: 10.1007/s11916-024-01249-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE OF REVIEW Chronic pain affects a significant portion of the population globally, making it a leading cause of disability. Understanding the multifaceted nature of chronic pain, its various types, and the intricate relationship it shares with risk factors, comorbidities, and mental health issues like depression and anxiety is critical for comprehensive patient care. Factors such as socioeconomic status (SES), age, gender, and obesity collectively add layers of complexity to chronic pain experiences and pose management challenges. RECENT FINDINGS Low SES presents barriers to effective pain care, while gender differences and the prevalence of chronic pain in aging adults emphasize the need for tailored approaches. The association between chronic pain and physical comorbidities like cardiovascular disease, chronic obstructive pulmonary disease (COPD), and diabetes mellitus reveals shared risk factors and further highlights the importance of integrated treatment strategies. Chronic pain and mental health are intricately linked through biochemical mechanisms, profoundly affecting overall quality of life. This review explores pharmacologic treatment for chronic pain, particularly opioid analgesia, with attention to the risk of substance misuse and the ongoing opioid epidemic. We discuss the potential role of medical cannabis as an alternative treatment with a nuanced perspective on its impact on opioid use. Addressing the totality and complexity of pain states is crucial to individualizing chronic pain management. With different types of pain having different underlying mechanisms, considerations should be made when approaching their treatment. Moreover, the synergistic relationship that pain states can have with other comorbidities further complicates chronic pain conditions.
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Affiliation(s)
- Sage V Hebert
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Melanie A Green
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Sydney A Mashaw
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - William D Brouillette
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Angela Nguyen
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Kylie Dufrene
- School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Anitha Shelvan
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Shilpadevi Patil
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Shahab Ahmadzadeh
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
| | - Sahar Shekoohi
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA.
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA
- Department of Pharmacology, Louisiana State University Health Sciences Center at Shreveport, Toxicology, and Neurosciences, Shreveport, LA, 71103, USA
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3
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Topping M, Fletcher J. Educational attainment, family background and the emergence of pain gradients in adulthood. Soc Sci Med 2024; 346:116692. [PMID: 38460426 PMCID: PMC10978221 DOI: 10.1016/j.socscimed.2024.116692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 03/11/2024]
Abstract
Current studies have indicated that the number of individuals living with pain has risen in recent years, with nearly half of all adults in some countries living with some form of pain. Such trends have prompted researchers to explore differences in pain across different sociodemographic groups, with a dominant focus on educational attainment. However, much of the studies fail to consider the confounding role of early life characteristics, such as family background. Using data on over 400,000 individuals from the UK Biobank, we look at how educational attainment is associated with nine different domains of pain (headache, facial, neck, back, hip, knee, stomach, all over, and no pain). Ultimately, we find that compared to those with no educational credentials, education is associated with anywhere between a 0.1-15% change in the likelihood of reporting pain, depending on pain type and education level, with the greatest change occurring in those with the highest level. Yet, when accounting for family background characteristics in the form of sibling fixed effects, nearly all relationships between education and pain fell by either 50% or were eliminated. We ultimately conclude that failure to consider early life characteristics, such as family background characteristics may lead to inflated estimates of pain, and that future research should delve into early life exposures and their influence on pain in adulthood.
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Affiliation(s)
- Michael Topping
- Department of Sociology, Center for Demography and Ecology, Center for Demography of Health and Aging, University of Wisconsin-Madison, United States.
| | - Jason Fletcher
- La Follette School of Public Affairs, Center for Demography of Health and Aging, University of Wisconsin-Madison, United States.
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4
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Yang Y, Sims KD, Lane NE, Duchowny KA, Torres JM. Perceived Neighborhood Characteristics and Later-Life Pain Outcomes: Evidence From the Health and Retirement Study. J Aging Health 2024; 36:246-256. [PMID: 37349863 PMCID: PMC10739572 DOI: 10.1177/08982643231185382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Objectives: This study examines whether perceived neighborhood characteristics relate to pain outcomes among middle-aged and older adults. Methods: Data were from the Health and Retirement Study (2006-2014; n = 18,814). Perceived neighborhood characteristics were physical disorder, social cohesion, safety, and social ties. We fitted adjusted generalized estimating equation models to evaluate prevalence, incidence, and recovery of moderate-to-severe limiting pain 2 years later. Results: The mean age of our sample was 65.3 years; 54.6% were female and 24.2% reported moderate-to-severe limiting pain at baseline. Positive neighborhood characteristics were associated with low prevalence (e.g., prevalence ratio [PR]: .71 for disorder) and reduced incidence (e.g., PR: .63 for disorder) of moderate-to-severe limiting pain. Positive neighborhood characteristics were associated with a high recovery rate from moderate-to-severe limiting pain (e.g., PR = 1.15 for safety), though the 95% CIs for disorder and cohesion crossed the null. Discussion: Neighborhood characteristics may be important determinants in predicting pain in later life.
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Affiliation(s)
- Yulin Yang
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Kendra D. Sims
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Nancy E. Lane
- Center for Musculoskeletal Health, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Kate A. Duchowny
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Jacqueline M. Torres
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
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5
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Zimmer Z, Zajacova A, Fraser K, Powers D, Grol-Prokopczyk H. A global comparative study of wealth-pain gradients: Investigating individual- and country-level associations. DIALOGUES IN HEALTH 2023; 2:100122. [PMID: 38099153 PMCID: PMC10718570 DOI: 10.1016/j.dialog.2023.100122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/27/2023] [Accepted: 03/05/2023] [Indexed: 12/17/2023]
Abstract
Pain is a significant yet underappreciated dimension of population health. Its associations with individual- and country-level wealth are not well characterized using global data. We estimate both individual- and country-level wealth inequalities in pain in 51 countries by combining data from the World Health Organization's World Health Survey with country-level contextual data. Our research concentrates on three questions: 1) Are inequalities in pain by individual-level wealth observed in countries worldwide? 2) Does country-level wealth also relate to pain prevalence? 3) Can variations in pain reporting also be explained by country-level contextual factors, such as income inequality? Analytical steps include logistic regressions conducted for separate countries, and multilevel models with random wealth slopes and resultant predicted probabilities using a dataset that pools information across countries. Findings show individual-level wealth negatively predicts pain almost universally, but the association strength differs across countries. Country-level contextual factors do not explain away these associations. Pain is generally less prevalent in wealthier countries, but the exact nature of the association between country-level wealth and pain depends on the moderating influence of country-level income inequality, measured by the Gini index. The lower the income inequality, the more likely it is that poor countries experience the highest and rich countries the lowest prevalence of pain. In contrast, the higher the income inequality, the more nonlinear the association between country-level wealth and pain reporting such that the highest prevalence is seen in highly nonegalitarian middle-income countries. Our findings help to characterize the global distribution of pain and pain inequalities, and to identify national-level factors that shape pain inequalities.
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Affiliation(s)
- Zachary Zimmer
- Department of Family Studies and Gerontology, Global Aging and Community Initiative, 166 Bedford Highway, McCain Centre 201C, Halifax, Nova Scotia B2M2J6, Canada
| | - Anna Zajacova
- Department of Sociology, Social Science Centre Room 5306, University of Western Ontario, London, Ontario N6A5C2, Canada
| | - Kathryn Fraser
- Global Aging and Community Initiative, 166 Bedford Highway, McCain Centre 201C, Halifax, Nova Scotia B2M2J6, Canada
| | - Daniel Powers
- Department of Sociology, RLP 2.622J, University of Texas at Austin, Austin, TX 78712-1086, USA
| | - Hanna Grol-Prokopczyk
- Department of Sociology, 430 Park Hall, University at Buffalo, Buffalo, NY 14260-4140, USA
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Zhang JK, Alimadadi A, Abolfotoh M, Mercier P, Mattei TA. Development of a Modified Bayonet Forceps for Improving Steerability of Paddle Lead Electrodes During Spinal Cord Stimulator Surgery: A Technical Note. Oper Neurosurg (Hagerstown) 2023; 25:285-291. [PMID: 37366619 DOI: 10.1227/ons.0000000000000779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/29/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Despite recent advancements in spinal cord stimulation (SCS) technology, the surgical instrumentation for placement of SCS paddle leads remains suboptimal. Therefore, we developed a novel instrument to improve the steerability of SCS paddle leads during surgical placement. METHODS A review of existing literature was performed to analyze workflow deficiencies in the standard instrumentation of SCS paddle lead placement. After a period of adaptation and iterative feedback with a medical instrument company, a new instrument was developed, tested at benchtop, and successfully incorporated into the surgical routine. RESULTS A standard bayonet forceps was modified to include hooked ends and a ribbed surface, providing the surgeon with greater control over the paddle lead. The new instrument also included bilateral metal tubes starting approximately 4 cm proximal from the edge of the forceps. The bilateral metal tubes, through which the SCS paddle lead wires are passed, serve as anchors to keep the wires away from the incision site. In addition, it permitted the paddle lead to assume a bent configuration, reducing its overall size and allowing it to be placed through a smaller incision and laminectomy. The modified bayonet forceps was successfully used intraoperatively for placement of SCS paddle lead electrodes in several surgeries. CONCLUSION The proposed modified bayonet forceps increased steerability of the paddle lead, facilitating optimal midline placement. The bent configuration of the device facilitated a more minimally invasive surgical approach. Future studies are needed to validate our single-provider experience and evaluate the impact of this new instrument on operating room efficiency.
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Affiliation(s)
- Justin K Zhang
- Division of Neurological Surgery, Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA
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Weissman JD, Russell D, Taylor J. The Relationship Between Financial Stressors, Chronic Pain, and High-Impact Chronic Pain: Findings From the 2019 National Health Interview Survey. Public Health Rep 2023; 138:438-446. [PMID: 35506496 PMCID: PMC10240893 DOI: 10.1177/00333549221091786] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Public health interventions to prevent financial stressors and reduce chronic pain and high-impact chronic pain (HICP) are important to potentially improve the health of the US population. The objectives of our study were to provide an update on the prevalence of chronic pain and HICP and to examine relationships between financial stressors and pain. METHODS We used data from a cross-sectional sample of adults aged ≥18 years (n = 31 997) collected by the 2019 National Health Interview Survey. We constructed bivariate and multivariate models to examine chronic pain and HICP in relation to financial worries, employment with wages, income, sociodemographic characteristics, number of chronic health conditions, and body mass index. RESULTS In fully adjusted multivariate regression models, having no employment with wages was strongly associated with increased risk for chronic pain (adjusted odds ratio [aOR] = 1.3; 95% CI, 1.2-1.5) and HICP (aOR = 1.6; 95% CI, 1.4-1.9). Worries about paying medical bills was associated with chronic pain (aOR = 1.1; 95% CI, 1.0-1.2) and HICP (aOR = 1.1; 95% CI, 1.0-1.3). Being unable to pay medical bills was associated with chronic pain (aOR = 2.1; 95% CI, 1.9-2.3) and HICP (aOR = 2.3; 95% CI, 2.0-2.6). Compared with having more income, having less income relative to the federal poverty level was associated with increased risk for chronic pain and HICP. CONCLUSIONS We found a strong relationship between financial worries, employment for wages, income, and self-reported chronic pain and HICP independent of poor physical health and body mass index. Interventions to reduce chronic pain and HICP should address economic instability and financial stressors.
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Affiliation(s)
- Judith D. Weissman
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, USA
| | - David Russell
- Department of Sociology, Appalachian State University, Boone, NC, USA
| | - John Taylor
- Department of Sociology, Florida State University, Tallahassee, FL, USA
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8
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Chen WC, Zhang LH, Bai YY, Liu YB, Liang JW, He HF. Nomogram prediction of chronic postsurgical pain in patients with lung adenocarcinoma after video-assisted thoracoscopic surgery: A prospective study. Front Surg 2022; 9:1004205. [PMID: 36439523 PMCID: PMC9681821 DOI: 10.3389/fsurg.2022.1004205] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/24/2022] [Indexed: 09/13/2023] Open
Abstract
Chronic postsurgery pain (CPSP) refers to persistent or repeated pain around the incision after surgery. Different from acute postoperative pain, the persistence of CPSP seriously affects the quality of life of patients. CPSP has a considerable global impact due to large surgical volumes. Although the development of video-assisted thoracoscopy (VATS) has reduced the risk of CPSP, it still seriously affects patients' quality of life. Clinical recognition of CPSP at an early stage is limited; therefore, we aimed to develop and validate a nomogram to identify the significant predictive factors associated with CPSP after VATS in patients with lung adenocarcinoma. We screened 137 patients with invasive adenocarcinoma of the lung from among 312 patients undergoing VATS. In this prospective study, patients were divided into the CPSP (n = 52) and non-CPSP (n = 85) groups according to the occurrence of CPSP. Relevant information was collected 1 day before surgery and 1-3 days after surgery, and the occurrence of CPSP was followed up by telephone at 3 months after surgery. Data on clinical characteristics and peripheral blood leukocyte miRNAs were used to establish a nomogram for predicting CPSP using least absolute shrinkage and selection operator (LASSO) regression methods. The area under curve (AUC) was used to determine the recognition ability of the nomograms. The model was subjected to correction and decision curve analyses. Four variables-body mass index (BMI), history of chronic pain, miR 550a-3p, and visual analog scale (VAS) score on postoperative day 2 (VAS2d)-were selected according to LASSO regression to build the nomogram. The nomogram demonstrated adequate calibration and discrimination in the prediction model, with an AUC of 0.767 (95% confidence interval: 0.679-0.856). The calibration plot showed the best fit between model predictions and practical observations, suggesting that the use of the proposed nomogram to predict CPSP is beneficial. A nomogram consisting of BMI, history of chronic pain, miR 550a-3p, and VAS2d predicted the risk of CPSP after VATS in patients with lung adenocarcinoma.
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Affiliation(s)
| | | | | | | | - Jin-wei Liang
- Department of Anesthesiology, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China
| | - He-fan He
- Department of Anesthesiology, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China
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9
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Elma Ö, Brain K, Dong HJ. The Importance of Nutrition as a Lifestyle Factor in Chronic Pain Management: A Narrative Review. J Clin Med 2022; 11:jcm11195950. [PMID: 36233817 PMCID: PMC9571356 DOI: 10.3390/jcm11195950] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
In everyday clinical practice, healthcare professionals often meet chronic pain patients with a poor nutritional status. A poor nutritional status such as malnutrition, unhealthy dietary behaviors, and a suboptimal dietary intake can play a significant role in the occurrence, development, and prognosis of chronic pain. The relationship between nutrition and chronic pain is complex and may involve many underlying mechanisms such as oxidative stress, inflammation, and glucose metabolism. As such, pain management requires a comprehensive and interdisciplinary approach that includes nutrition. Nutrition is the top modifiable lifestyle factor for chronic non-communicable diseases including chronic pain. Optimizing one’s dietary intake and behavior needs to be considered in pain management. Thus, this narrative review reports and summarizes the existing evidence regarding (1) the nutrition-related health of people experiencing pain (2) the underlying potential mechanisms that explain the interaction between nutrition and chronic pain, and (3) the role of nutrition screening, assessment and evaluation for people experiencing pain and the scope of nutrition practice in pain management. Future directions in the nutrition and chronic pain field are also discussed.
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Affiliation(s)
- Ömer Elma
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
| | - Katherine Brain
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia
| | - Huan-Ji Dong
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden
- Correspondence:
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10
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Berry KM, Garcia S, Warren JR, Stokes AC. Association of Weight at Different Ages and All-Cause Mortality Among Older Adults in the US. J Aging Health 2022; 34:705-719. [PMID: 35220792 PMCID: PMC9411264 DOI: 10.1177/08982643211059717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Objective: Assess the association of BMI and BMI change with mortality. Methods: Using data from the Wisconsin Longitudinal Study (WLS) on participants born mainly in 1939 (n=4922), we investigated the associations between various measures of BMI across the life course (age 54 BMI; age 65 BMI; age 72 BMI; lifetime maximum BMI; BMI change between ages 54 and 65; BMI change between ages 65 and 72) and mortality. We also assessed whether these associations are mediated by late life health. Results: BMI at age 54 was more strongly associated with late life mortality than BMI at older ages. The association between BMI change and mortality varied based on the timing of weight change. Health at age 72, particularly self-rated health, diabetes, and physical functioning, mediated the observed associations. Conclusion: Knowing older people's weight at midlife and how their weight has changed may be more important in assessing late life mortality risk than their current weight.
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Affiliation(s)
- Kaitlyn M. Berry
- University of Minnesota School of Public Health, Minneapolis, MN, USA
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11
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Peele M, Schnittker J. The Nexus of Physical and Psychological Pain: Consequences for Mortality and Implications for Medical Sociology. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022; 63:210-231. [PMID: 34964387 DOI: 10.1177/00221465211064533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Although physical pain lies at the intersection of biology and social conditions, a sociology of pain is still in its infancy. We seek to show how physical and psychological pain are jointly parts of a common expression of despair, particularly in relation to mortality. Using the 2002-2014 National Health Interview Survey Linked Mortality Files (N = 228,098), we explore sociodemographic differences in the intersection of physical and psychological pain (referred to as the "pain-distress nexus") and its relationship to mortality among adults ages 25 to 64. Results from regression and event history models reveal that differences are large for the combination of the two, pointing to an overlooked aspect of health disparities. The combination of both high distress and high pain is most prevalent and most strongly predictive of mortality among socioeconomically disadvantaged, non-Hispanic whites. These patterns have several implications that medical sociology is well positioned to address.
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Affiliation(s)
- Morgan Peele
- Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Jason Schnittker
- Sociology at the University of Pennsylvania, Philadelphia, PA, USA
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12
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Conde-Pipó J, Bouzas C, Mariscal-Arcas M, Tur JA. Association between Functional Fitness and Health-Related Quality of Life in the Balearic Islands' Old Adults with Metabolic Syndrome. Nutrients 2022; 14:nu14091798. [PMID: 35565767 PMCID: PMC9103052 DOI: 10.3390/nu14091798] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/14/2022] [Accepted: 04/24/2022] [Indexed: 11/16/2022] Open
Abstract
Research assessing the relationship between functional fitness (FF) and health-related quality of life (HRQoL) is still scarce. The objective of this research is to assess the association between FF and HRQoL in older adults with metabolic syndrome (MetS) from Balearic Islands (Spain). The design is a cross-sectional, descriptive, and comparative study involving 209 participants (42.2% women). The sociodemographic data and medical history of the participants were collected. Physical activity was evaluated using the Spanish version of the Rapid Assessment of Physical Activity Questionnaire. Anthropometrics and blood pressure were measured. Glucose, total cholesterol, high-density lipoprotein cholesterol, and triglyceride plasma levels were measured. A battery of functional fitness tests was applied. HRQoL was measured with the Spanish version of the SF-36 questionnaire. Adherence to the Mediterranean dietary pattern was assessed. In older subjects with MetS, a higher FF score and, within it, endurance, lower body strength, one-leg balance, and agility are positively associated with lower physical function (p < 0.001; d = 0.56), better general health (p = 0.019; d = 0.35), and better summary physical component of HRQoL (p < 0.001; d = 0.57). The FF score and HRQoL physical component are both positively associated with high levels of physical activity (ORadj = 10.3, IC 4.19−28.2, p < 0.001; ORadj = 3.25, IC 1.44−7.72, p < 0.005). Older adults with MetS should consider practicing physical activity above the general recommendations to improve their functional fitness and health status and quality of life.
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Affiliation(s)
- Javier Conde-Pipó
- Department of Didactics of Musical, Plastic and Corporal, Faculty of Education Sciences, University of Granada, 18071 Granada, Spain;
| | - Cristina Bouzas
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain;
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Miguel Mariscal-Arcas
- Department of Nutrition and Food Science, School of Pharmacy, University of Granada, 18071 Granada, Spain;
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain;
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-971-1731; Fax: +34-971-173184
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13
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Hurley L, Stillerman A, Feinglass J, Percheski C. Adverse Childhood Experiences among Reproductive Age Women: Findings from the 2019 Behavioral Risk Factor Surveillance System. Womens Health Issues 2022; 32:517-525. [PMID: 35469680 DOI: 10.1016/j.whi.2022.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 03/01/2022] [Accepted: 03/17/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Adverse childhood experiences (ACEs) are associated with many negative health outcomes. Despite this well-documented association, most research on how health conditions affect women's preconception and perinatal health overlooks ACEs. METHODS This study analyzes self-reported ACE history and health outcomes among young adults (ages 18-39) using data from the 2019 Behavioral Risk Factor Surveillance System. Our aims were to 1) assess differences by gender in overall ACE scores and specific ACEs; 2) identify trends in women's ACE scores by birth cohort; and 3) estimate the association of ACE scores with health conditions that increase risk for adverse perinatal outcomes. RESULTS Findings include that women had higher overall ACE scores than men and that women were more likely to report experiencing seven of the eight ACEs queried. More than 23% of women respondents reported an ACE score of 4+, with a 3-percentage point difference between the youngest and oldest women in our sample. Compared with those reporting zero ACEs, women with four or more ACEs were almost four times as likely to report a history of depression and more than twice as likely to report fair or poor health, even after accounting for sociodemographic characteristics. Women with four or more ACEs were 62% more likely to have obesity, 41% more likely to report a hypertension diagnosis, and 36% more likely to report a diabetes diagnosis than those with zero ACEs. CONCLUSIONS ACEs are a root cause in the development of adverse health conditions in young women, and their prevention should be central to policies aimed at improving women and children's well-being.
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Affiliation(s)
- Laura Hurley
- Northwestern University Masters In Public Health Degree Program, Chicago, Illinois
| | - Audrey Stillerman
- Department of Family and Community Medicine, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
| | - Joe Feinglass
- Division of General Internal Medicine and Gerontology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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14
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Dagnino APA, Campos MM. Chronic Pain in the Elderly: Mechanisms and Perspectives. Front Hum Neurosci 2022; 16:736688. [PMID: 35308613 PMCID: PMC8928105 DOI: 10.3389/fnhum.2022.736688] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/27/2022] [Indexed: 12/12/2022] Open
Abstract
Chronic pain affects a large part of the population causing functional disability, being often associated with coexisting psychological disorders, such as depression and anxiety, besides cognitive deficits, and sleep disturbance. The world elderly population has been growing over the last decades and the negative consequences of chronic pain for these individuals represent a current clinical challenge. The main painful complaints in the elderly are related to neurodegenerative and musculoskeletal conditions, peripheral vascular diseases, arthritis, and osteoarthritis, contributing toward poorly life quality, social isolation, impaired physical activity, and dependence to carry out daily activities. Organ dysfunction and other existing diseases can significantly affect the perception and responses to chronic pain in this group. It has been proposed that elderly people have an altered pain experience, with changes in pain processing mechanisms, which might be associated with the degeneration of circuits that modulate the descending inhibitory pathways of pain. Aging has also been linked to an increase in the pain threshold, a decline of painful sensations, and a decrease in pain tolerance. Still, elderly patients with chronic pain show an increased risk for dementia and cognitive impairment. The present review article is aimed to provide the state-of-art of pre-clinical and clinical research about chronic pain in elderly, emphasizing the altered mechanisms, comorbidities, challenges, and potential therapeutic alternatives.
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Affiliation(s)
- Ana P. A. Dagnino
- Programa de Pós-graduação em Medicina e Ciências da Saúde, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria M. Campos
- Programa de Pós-graduação em Medicina e Ciências da Saúde, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- *Correspondence: Maria M. Campos, ,
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15
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Glei DA, Stokes AC, Weinstein M. Widening Socioeconomic Disparities in Pain and Physical Function Among Americans Are Linked with Growing Obesity. J Aging Health 2022; 34:78-87. [PMID: 34459255 PMCID: PMC8751296 DOI: 10.1177/08982643211028121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objectives: We investigate whether obesity accounts for widening socioeconomic disparities in pain. Methods: Based on nationally representative samples of Americans aged 25-74 in 1995-1996 and 2011-2014, we use logistic regression to model period change in headaches, backaches, and joint aches as well as physical limitations and to determine whether those changes vary by a multidimensional measure of socioeconomic status. Results: Prevalence of backaches, joint aches, physical limitations, and obesity increased between the mid-1990s and the early 2010s, particularly among more disadvantaged Americans. Socioeconomic disparities in frequent backaches, frequent joint pain, and physical limitations more than doubled over this period. We estimate that obesity and health conditions may account for nearly a quarter of the widening disparity in frequent backaches and about half of the widening disparity in frequent joint pain and physical limitations. Discussion: Widening disparities in backaches, joint pain, and physical limitations have coincided with growing obesity.
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Affiliation(s)
- Dana A. Glei
- Center for Population and Health, Georgetown University, Washington, DC
| | - Andrew C. Stokes
- Department of Global Health, Boston University School of Public Health, Boston, MA
| | - Maxine Weinstein
- Center for Population and Health, Georgetown University, Washington, DC
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16
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Glei DA, Weinstein M. Disadvantaged Americans are suffering the brunt of rising pain and physical limitations. PLoS One 2021; 16:e0261375. [PMID: 34882731 PMCID: PMC8659634 DOI: 10.1371/journal.pone.0261375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/29/2021] [Indexed: 11/25/2022] Open
Abstract
Using data from three national surveys of US adults (one cohort and two cross-sectional studies, covering the period from the mid-1990s to the mid-2010s), we quantify the degree to which disparities by socioeconomic status (SES) in self-reported pain and physical limitations widened and explore whether they widened more in midlife than in later life. Unlike most prior studies that use proxy measures of SES (e.g., education), we use a multidimensional measure of SES that enables us to evaluate changes over time in each outcome for fixed percentiles of the population, thereby avoiding the problem of lagged selection bias. Results across multiple datasets demonstrate that socioeconomic disparities in pain and physical limitations consistently widened since the late 1990s, and if anything, widened even more in midlife than in late life (above 75). For those aged 50-74, the SES disparities in most outcomes widened by more than 50% and in some cases, the SES gap more than doubled. In contrast, the magnitude of SES widening was much smaller above age 75 and, in the vast majority of cases, not significant. Pain prevalence increased at all levels of SES, but disadvantaged Americans suffered the largest increases. Physical function deteriorated for those with low SES, but there was little change and perhaps improvement among the most advantaged Americans. At the 10th percentile of SES, the predicted percentage with a physical limitation at age 50 increased by 6-10 points between the late-1990s and the 2010s, whereas at the 90th percentile of SES, there was no change in two surveys and in the third survey, the corresponding percentage declined from 31% in 1996-99 to 22% in 2016-18. The worst-off Americans are being left behind in a sea of pain and physical infirmity, which may have dire consequences for their quality of life and for society as a whole (e.g., lost productivity, public costs).
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Affiliation(s)
- Dana A. Glei
- Center for Population and Health, Georgetown University, Washington, DC, United States of America
| | - Maxine Weinstein
- Center for Population and Health, Georgetown University, Washington, DC, United States of America
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Abstract
Chronic pain is a common, costly, and consequential health problem. However, despite some important analytic contributions, sociological research on pain has not yet coalesced into a unified subfield. We present three interrelated bodies of evidence and illustrative new empirical findings using 2010 to 2018 National Health Interview Survey data to argue that pain should have a central role in sociological investigations of health. Specifically, we contend that (1) pain is a sensitive barometer of population health and well-being, (2) pain is emblematic of many contested and/or chronic conditions, and (3) pain and pain treatment reflect and have wide-ranging implications for public policy. Overall, whether pain is analyzed quantitatively or qualitatively-focusing on its distribution in the population, its social causes and consequences, or its subjective meanings for individuals-pain reflects social conditions, sociopolitical context, and health-related beliefs of a society. Pain is thus an important frontier for future sociological research.
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18
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Marques Miranda C, de Lima Campos M, Leite-Almeida H. Diet, body weight and pain susceptibility - A systematic review of preclinical studies. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2021; 10:100066. [PMID: 34195483 PMCID: PMC8237587 DOI: 10.1016/j.ynpai.2021.100066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/26/2021] [Accepted: 06/11/2021] [Indexed: 02/07/2023]
Abstract
Obesity has been associated with increased chronic pain susceptibility but causes are unclear. In this review, we systematize and analyze pain outcomes in rodent models of obesity as these can be important tools for mechanistic studies. Studies were identified using MEDLINE/PubMed and Scopus databases using the following search query: (((pain) OR (nociception)) AND (obesity)) AND (rat OR (mouse) OR (rodent))). From each eligible record we extracted the following data: species, strain, sex, pain/obesity model and main behavioral readouts. Out of 695 records 33 were selected for inclusion. 27 studies assessed nociception/acute pain and 17 studies assessed subacute or chronic pain. Overall genetic and dietary models overlapped in pain-related outcomes. Most acute pain studies reported either decreased or unaltered responses to noxious painful stimuli. However, decreased thresholds to mechanical innocuous stimuli, i.e. allodynia, were frequently reported. In most studies using subacute and chronic pain models, namely of subcutaneous inflammation, arthritis and perineural inflammation, decreased thresholds and/or prolonged pain manifestations were reported in obesity models. Strain comparisons and longitudinal observations indicate that genetic factors and the time course of the pathology might account for some of the discrepancies observed across studies. Two studies reported increased pain in animals subjected to high fat diet in the absence of weight gain. Pain-related outcomes in experimental models and clinical obesity are aligned indicating that the rodent can be an useful tool to study the interplay between diet, obesity and pain. In both cases weight gain might represent only a minor contribution to abnormal pain manifestation.
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Affiliation(s)
- Carolina Marques Miranda
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- ICVS/3B’s - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Mariana de Lima Campos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- ICVS/3B’s - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Hugo Leite-Almeida
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- ICVS/3B’s - PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Zajacova A, Grol-Prokopczyk H, Zimmer Z. Pain Trends Among American Adults, 2002-2018: Patterns, Disparities, and Correlates. Demography 2021; 58:711-738. [PMID: 33834222 PMCID: PMC8035485 DOI: 10.1215/00703370-8977691] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Determining long-term trends in chronic pain prevalence is critical for evaluating and shaping U.S. health policies, but little research has examined such trends. This study (1) provides estimates of pain trends among U.S. adults across major population groups; (2) tests whether sociodemographic disparities in pain have widened or narrowed over time; and (3) examines socioeconomic, behavioral, psychological, and medical correlates of pain trends. Regression and decomposition analyses of joint, low back, neck, facial/jaw pain, and headache/migraine using the 2002-2018 National Health Interview Survey for adults aged 25-84 (N = 441,707) assess the trends and their correlates. We find extensive escalation of pain prevalence in all population subgroups: overall, reports of pain in at least one site increased by 10%, representing an additional 10.5 million adults experiencing pain. Socioeconomic disparities in pain are widening over time, and psychological distress and health behaviors are among the salient correlates of the trends. This study thus comprehensively documents rising pain prevalence among Americans across the adult life span and highlights socioeconomic, behavioral, and psychological factors as important correlates of the trends. Chronic pain is an important dimension of population health, and demographic research should include it when studying health and health disparities.
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Affiliation(s)
- Anna Zajacova
- Department of Sociology, The University of Western Ontario, London, Ontario, Canada
| | - Hanna Grol-Prokopczyk
- Department of Sociology, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Zachary Zimmer
- Department of Family Studies and Gerontology and Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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