Chronic pain and quality of life among older people

Abstract: The overall aim was to investigate chronic pain, quality of life and factors associated with pain as well as with quality of life among older people, aged 75 years and above. Further, the aim was to investigate the use of methods for pain management and their effects for those with pain and in need of help for daily living. Data were collected from a larger population study and in the first study 4093 people aged 75–105 years were studied regarding the prevalence of chronic pain, factors associated with pain and quality of life (QoL). Those who reported pain (n=1654) were compared with those who did not (n=2439). The aim of the second study was to study (n=1622) the oldest old (aged 85+) in pain in comparison with those not in pain regarding QoL and related factors. In the third study (n=532; aged 75–102 years) QoL and factors associated with QoL were investigated among those in pain and in need of help for daily living. In the fourth and last study those in pain and in need of help for daily living (n=294; aged 76–100 years) were investigated regarding the use of methods for pain management and comparisons were made between different living conditions. The results showed that chronic pain is common and often a major problem among older people. With higher age the prevalence of pain tended to be more prevalent, as did other complaints, such as functional limitations, fatigue, depressed mood, that were related to both age and pain. Those in chronic pain were most likely to suffer more from other complaints than those without pain, because the prevalence as well as the severity of these related complaints was even higher. Also QoL was significantly lower in the higher age groups and even lower among those in pain. Besides the fact that functional limitations (e.g. walking problems/mobility problems) were more common, also the need for help with IADL and PADL was higher in higher ages and among those in pain. High degree of pain, related complaints and low QoL were above all identified among the oldest old (85+) and among those in need of help to manage daily living. The use of various methods for pain management was found in this thesis to be sparse and tend to be unsystematic among those in need of help to manage daily living. A cluster analysis revealed above all two main clusters. The first cluster represented those using few (md: 2) and the most common methods used (prescribed medicine, rest, distraction). This first cluster included those who were significantly older than the second cluster that represented those that used more methods (md: 6) but reported significantly more pain severity and interference in daily life. Among the oldest old (in pain) functional limitations, fatigue and depressed mood were areas to be intervened against to improve their QoL. Also living alone and living in sheltered housing that was associated with low QoL, as well as the economic situation must be considered. For those in pain and in need of help in daily living, functional limitations, fatigue, sleeping problems, depressed mood and living in special accommodations were associated with low QoL.