Pain in older adults linked with biopsychosocial risk factors

By Melanie Hinze
Biopsychosocial risk factors are linked with the onset of troubling pain in adults aged 50 years or more, according to research published in Pain.

The authors of the prospective study assessed 4458 middle-aged and older adults from the Irish Longitudinal Study on Ageing who were without frequent, troubling pain at baseline. They used latent class analysis, based on 11 potential biopsychosocial risk factors, to identify, and assign participants to, four risk classes. The biopsychosocial risk factors used were physical activity, sleep, alcohol, smoking, BMI, depression, anxiety, loneliness, health, multimorbidity and disability. The four risk classes were labelled low risk (good mental and physical health; 51.2% of participants), high risk (poor mental and physical health; 7.8%) and intermediate risk, comprising a physical health risk group (28%) and mental health risk group (13%). 

At two-years’ follow up, 17.9% of all participants reported being troubled by pain and, although the group was small, those in the high-risk group were over three times more likely to develop pain than those in the low-risk group (odds ratio, 3.16).

Additionally, 22.9% of those in the high-risk group developed multisite pain or single-site pain affecting usual activities compared with only 5.6% of those in the low-risk group.

The authors concluded that the development of pain in older people was linked to a range of biopsychosocial risk factors. They argued this reinforced the hypothesis that pain in older adults was linked with frailty or unhealthy ageing and as such, treating pain as a standalone symptom may be of limited value.

Professor Andrea Maier, Professor of Gerontology at the University of Melbourne and Divisional Director of Medicine and Community Care at the Royal Melbourne Hospital, agreed, saying that mental and physical health was of utmost importance to avoid being troubled with pain in the future.

 ‘This study demonstrates that the underlying causes of mental and physical symptoms might directly or indirectly lead to pain sensations,’ she told Medicine Today. ‘We therefore should target underlying causes rather than treating pain as a sole symptom.’
Pain 2018; 159: 1631-1640.