O22. Widespread and Regional Pain Predict Social Participation Restriction in Older Adults: A Prospective Cohort Study

Wilkie, Ross; Bucknall, Milica; Jordan, Kelvin; McBeth, John

Abstract

Background: In older people maintaining social participation (a measure of social function and social roles, such as being a worker, carer or community member), is associated with reduced morbidity and mortality. Social participation restriction results from complex interactions between health, physical capacity, psychological, socio-demographic and environmental factors. Musculoskeletal pain is associated with participation restriction although due to the cross-sectional nature of previous studies the temporal relationship is unclear. This longitudinal study tested the hypotheses that musculoskeletal pain would predict social participation restriction and that the strength of that relationship would be stronger in those with more extensive pain.

Methods: The study was set within the North Staffordshire Osteoarthritis Project (NorStOP), a population-based prospective cohort study of adults aged 50 years and over. Participants were those who completed questionnaires at baseline, 3- and 6-year follow-ups (n = 4826). Participants were classified into those reporting no, regional or widespread pain (WP) (ACR criteria) at baseline. The Keele Assessment of Participation (KAP), an assessment tool validated for use in older people, measures 11 aspects of participation. Zero-inflated poisson regression models tested the association between baseline pain status and number of participation restrictions (range from 0 to 11) at 3 and 6 years. Unadjusted analyses were initially performed and then adjusted for putative confounders: socio-demographics (age, gender, education, occupational class); time-dependent measures of BMI, cognitive impairment, anxiety and depression, comorbidity (count of self-reported morbidities), financial strain, social network; and baseline KAP score. Results were expressed as an incidence rate ratio (IRR) with 95% CI.

Results: The median age of subjects was 59 (inter-quartile range: 54 to 67) and 2751 (57%) were female. At baseline, 1378 (29%) had no pain, 2188 (45%) had regional pain, 1260 (26%) had WP. Of those 31%, 40% and 55% had restriction in at least one aspect of participation respectively. Baseline regional and widespread pain were associated with increasing participation restriction at 3 and 6 years; unadjusted IRR (95% CI) at 3 years was 1.38 (1.25, 1.54) for regional pain and 1.81 (1.63, 2.00) for WP; 6 years regional pain 1.22 (1.12, 1.34) and WP 1.53 (1.40, 1.68). While attenuated these associations persisted and were significant following adjustment for covariates: 3 years 1.18 (1.06, 1.31), 1.21 (1.08, 1.35); 6 years 1.12 (1.02, 1.23) and 1.15 (1.04, 1.27), respectively.

Conclusions: Independent of known risk factors, having musculoskeletal pain, and the extent of that pain, were important predictors of social participation restriction. Future studies should seek to determine the mechanisms of this relationship that may be targeted to increase social participation.

Citation

Wilkie, R., Bucknall, M., Jordan, K., & McBeth, J. (2013, April). O22. Widespread and Regional Pain Predict Social Participation Restriction in Older Adults: A Prospective Cohort Study. Paper presented at Rheumatology 2013, Birmingham, UK

• Presentation Conference Type: Conference Paper (unpublished)
• Conference Name: Rheumatology 2013
• Conference Location: Birmingham, UK
• Start Date: Apr 23, 2013
• End Date: Apr 25, 2013
• Deposit Date: Sep 19, 2023
• Publisher URL: https://academic.oup.com/rheumatology/article/52/suppl_1/i33/1929284