Daily pain and functional decline among old-old adults living in the community: results from the ilSIRENTE Study

Abstract

Few studies have assessed the impact of pain on physical function among old-old subjects. The aim of the present observational study was to evaluate the association between presence of daily pain and incident disability in elderly subjects aged 80 years or older living in the community. We used data from the "Invecchiamento e Longevità nel Sirente" (ilSIRENTE) project, a two-year longitudinal study enrolling subjects aged 80 years or older. Daily pain was defined as any type of pain or discomfort in any part of the body manifested every day over the seven days preceding the baseline assessment. Disability in performing activities of daily living (ADLs) was defined as the need of assistance in one or more of the following ADLs: eating, dressing, transferring, mobility in bed, personal hygiene, and toileting. The mean age of 204 subjects participating to this study was 84.3 years (standard deviation [SD]: 3.8), and 135 (SD: 66.1%) were women. Of the total sample, 103 subjects (50.4%) presented with daily pain. After a two-year follow-up, 25 of 103 (24.2%) participants with daily pain and 14 of 101 (13.9%) without daily pain developed disability. After adjusting for potential confounders, presence of daily pain was associated with an increased risk of disability, but this association did not reach statistical significance (hazard ratio [HR]: 1.87; 95% confidence interval [CI]: 0.92-4.26). The risk of disability increased with pain severity. Compared with subjects without daily pain, the risk of incident disability was higher for participants with mild pain (HR: 1.35; 95% CI: 0.65-3.28) and significantly higher for those with moderate to severe pain (HR: 6.94; 95% CI: 2.00-23.01). In conclusion, among very old subjects living in the community, moderate to severe daily pain is associated with a significant increased risk of disability, irrespective of potential confounders.