Characteristics and impact of chronic pain and pain management in older adults

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Project Summary/Abstract Approximately 38.5% of Americans >65 years of age report chronic pain lasting 6 months or longer. This percentage is expected to increase given the growth in the older adult population and the associated growth of chronic conditions that can contribute to pain. Chronic pain tends to be more complex in older adults with ~70% of them describing pain in multiple sites and over 60% describing multiple types of pain. To date, no large national sample of older adults provides detailed, longtitudinal information on the experience of chronic pain in older adults; the pharmacologic and nonpharmacologic strategies that older adults are using to manage their chronic pain; and the impact of chronic pain on important person-centered outcomes. The proposed study will fill these significant gaps in knowledge by conducting the first national longitudinal study focused on chronic pain in older adults. In a large national sample of 1888 older adults, of whom 1,232 have chronic pain (i.e., pain >6 months duration) and 656 do not have chronic pain, we aim to: 1) Determine the prevalence and characteristics (i.e. quality, severity, interference) of chronic pain as well as identify the pharmacologic and non-pharmacologic treatments used to manage chronic pain; 2) Evaluate for longitudinal differences in biological, psychological, social factors, as well as physical and cognitive function and QoL between older adults with and without chronic pain; and 3) Examine the longitudinal relationships between chronic pain (i.e., worst pain score) and patient reported outcomes (i.e., physical function, cognitive function, QoL). We will determine which biological, psychological, and social factors at enrollment are associated with changes in the trajectories of chronic pain, identify subgroups of older adults with distinct pain profiles using latent profile analysis, and determine how changes in the trajectories of physical function, cognitive function, and QoL are associated with these distinct pain profile classes. Informed by a better understanding of pain characteristics, factors associated with chronic pain, treatment approaches and long-term impact, we will be equipped to develop and test tailored interventions that target subgroups of older patients, with the goal of improving the management of chronic pain, as well as overall function and QoL.