Pain Medicine  |   April 2017
Impact of Pain on Incident Risk of Disability in Elderly Japanese: Cause-specific Analysis
Author Notes
  • From the Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health (Y.K., Y.S., K.S., Y.T., I.T.) and Department of Anesthesiology and Perioperative Medicine (Y.K., Y.E., H.T., M.Y.), Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Submitted for publication July 25, 2016. Accepted for publication January 4, 2017.
    Submitted for publication July 25, 2016. Accepted for publication January 4, 2017.×
  • Address correspondence to Dr. Kaiho: Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980–8575, Japan. yu.kaiho@med.tohoku.ac.jp. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Pain Medicine / Clinical Science / Geriatric Anesthesia / Pain Medicine
Pain Medicine   |   April 2017
Impact of Pain on Incident Risk of Disability in Elderly Japanese: Cause-specific Analysis
Anesthesiology 4 2017, Vol.126, 688-696. doi:10.1097/ALN.0000000000001540
Anesthesiology 4 2017, Vol.126, 688-696. doi:10.1097/ALN.0000000000001540
Abstract

Background: Although several cross-sectional studies have reported that pain is associated with functional disability in the elderly, data regarding a longitudinal association between pain and disability are inconsistent. This study aimed to investigate the association of pain severity with subsequent functional disability due to all causes as well as stroke, dementia, and joint disease/fracture.

Methods: The authors conducted a prospective cohort study of 13,702 Japanese individuals aged 65 yr or older. Information regarding pain severity during the previous 4 weeks and other lifestyle factors was collected via questionnaire in 2006. Data on the incidence of functional disability were retrieved from the Long-term Care Insurance database. Cox proportional hazards regression analysis was used to estimate the multivariate-adjusted hazard ratios for incident functional disability.

Results: The authors documented 2,686 (19.6%) cases of incident functional disability. The multivariate hazard ratio of functional disability was 1.15 (95% CI, 1.02 to 1.31) among respondents with moderate pain and 1.31 (95% CI, 1.12 to 1.54) among respondents with severe pain in comparison with those without pain (P trend < 0.001). These positive associations were particularly remarkable for disability due to joint disease/fracture: the multivariate hazard ratio was 1.88 (95% CI, 1.37 to 2.58) for moderate pain and 2.76 (95% CI, 1.93 to 3.95) for severe pain (P trend < 0.001). There was a negative association between pain severity and disability due to dementia (P trend = 0.041) and no significant association between pain severity and disability due to stroke.

Conclusions: Among elderly Japanese individuals, the authors found a significant positive association between pain severity and future incident functional disability.