Table 6.
Correlates of pain with physical function
| Correlates of pain and ADL or IADL | |||||
|---|---|---|---|---|---|
| First author | N | Pain: prevalence | Physical function: prevalence | Correlates of pain with ADL or IADL | Quality of study |
| Brummel-Smith 200236 | 104 (excluding those unable to self-report pain) | Moderate-severe pain 60 %, no-mild pain 40 % (50 subject unable to answer) | ≥1 ADL limitations | SOR 1.9 (95 % CI: 0.6-6.0) with ≥ 1 ADL limitation | 7 |
| 92 % in dementia sample (n = 154) | |||||
| Cipher 20044 | 234 | Persistent pain 72 % | ADL independency mean 0.09 (SD 0.99) | Correlations with GMPI ’pain and suffering’ | 7.5 |
| r = −0.04 (α > 0.05) with ADL independency | |||||
| Shega 200544 | 115 | Any current pain self-report 32 %, caregiver report 53 % | KATZ mean 8.5 (SD 2.7), IADL mean 15.3 (SD 3.9) | For self-report pain | 9.5 |
| No association ADL and IADL (p > 0.05) | |||||
| For caregiver pain report | |||||
| No association with ADL or IADL (p > 0.05) | |||||
| Shega 201045 | 5549 | Moderate or greater pain: 35.8 % | Any IADL impairment: 66.5 % | OR = 1.74 (95 % CI: 1.15-2.62) with any iADL impairment | 9 |
| (Adjusted for demographics) | |||||
| Torvik 201048 | 106 | Current pain in total group 55 %, in cognitive impaired group 52 % | Highly or moderate ADL dependent 36 % | p = 0.20 for current pain and ADL | 6.5 |
| SOR = 0.5 (95 % CI: 0.2-1.2) for current pain and ADL high/medium v.s. low | |||||
| Tosato 20123 | 2822 | Any pain 19 % (moderate/severe/excruciating pain 13 %) | No disability 8 %, assistance required 43 %, dependent 49 % | SOR 1.0 (95 % CI: 0.9-1.2) with ADL-dependent | 11.5 |
| SOR 0.9 (95 % CI: 0.75-1.09) with ADL assistance required | |||||
| (Adjusted for age, gender, country, cognitive impairment, number of diseases, ischemic heart disease, stroke, falls, communication problems, and a flare-up of a chronic or recurrent condition) | |||||
| Correlates of pain and other functional impairments | |||||
| First author | N | Pain: prevalence | Physical function: prevalence | Correlates of pain with ADL or IADL | Quality of study |
| Black 200639 | 123 | Pain 63 % | Nutrition/hydration problems total sample 85 % | SOR 1.9 (95 % CI: 0.7-5.3) with nutrition/hydration problems | 6.5 |
| Brummel-Smith 200240 | 104 (excluding those unable to self-report pain) | Moderate-severe pain 60 %, no-mild pain 40 % (50 subject unable to answer) | ≥1 ADL limitations | SOR 1.6 (95 % CI: 0.6-4.2) with bladder incontinence | 7 |
| 92 % in dementia sample (n = 154) | |||||
| D’Astolfo 200644 | 140 | Pain 64 % (musculoskeletal pain 40 %) | Use of wheel chair 60 % | SOR 1.5 (95 % CI: 0.7-3.0) with use of wheel chair or bedridden | 7 |
| Requires assistance 34 % | SOR 1.0 (95 % CI: 0.5-2.0) with requires assistance | ||||
| (Analyses in sample of no dementia-severe dementia) | |||||
| Lin 201146 | 112 | Observed pain 37 % (PAINAD > =2) | Being restrained 46 %; observed care activities: bathing 43 %, assisted transfer 31 %, self-transfer 26 % | OR = 5.4 (95 % CI: 2.3-12.5) and AOR = 3.0 (95 % CI: 1.0-8.7) with being restrained | 12 |
| OR = 23.4 (95 % CI: 3.0-188) and AOR = 19.2 (95 % CI: 2.3-162) with bathing | |||||
| OR = 29.7 (95 % CI: 3.6-242) and AOR = 11.3 (95 % CI: 1.2-102) with assisted transfer, both compared to self-transfer | |||||
| (Adjusted for gender, age, wound, restraint, tube present in body, recent fall, severity of dementia and type of activity) | |||||
| Williams 200543 | 331 | Pain 21 %, in nh 23 %, in rc/al 20 % (self-report for subgroup MMSE > 10 was higher: 39 % and 25 %) | Low activity 47 %, immobile 12 % | OR = 0.65 (95 % CI: 0.38-1.11) and AOR = 0.64 (95 % CI: 0.37-1.10) with low activity | 10 |
| Low food intake 53 % | OR = 1.1 (95 % CI: 0.49-2.29) and AOR = 0.8 (95 % CI: 0.37-1.69) with immobility | ||||
| Low fluid intake 51 % | OR = 1.18 (95 % CI: 0.64-2.17) and AOR = 1.03 (95 % CI: 0.56-1.87) with low food intake | ||||
| OR = 1.20 (95 % CI: 0.67-2.15) and AOR 1.14 (95 % CI: 0.66-1.99) with low fluid intake | |||||
| (Adjusted for: sex, race, age, cognitive status, number of 10 comorbidities, impairments of 7 activities of daily living) | |||||
Abbreviations: SOR Self-Calculated Odds Ratio, ADL Activities of Daily Living, SD Standard Deviation, r correlation coefficient, GMPI Geriatric Multidimensional Pain and Illness Inventory, PAINAD Pain Assessment in Advanced Dementia, OR Odds Ratio, AOR Adjusted Odds Ratio, KATZ Index of Independence in Activities of Daily Living, IADL Instrumental Activities of Daily Living, nh nursing home, rc/al residential care/assisted living, MMSE Mini Mental State Examination