Table 3.
Adjusted Associations between Uncontrolled Pain and Risk of Depression and Behavioral Symptoms among Long-term Care Residents with ADRD
| Analysis | Risk for depression | Risk for behavioral symptoms | ||
|---|---|---|---|---|
| Hazard ratio (95% CI) | P-value | Hazard ratio (95% CI) | P-value | |
| Main analysis | P-value | |||
| Conventional models | ||||
| Without adjustment | 1.35 (1.25–1.46) | <.001 | 1.22 (1.14–1.30) | <.001 |
| Adjusted for baseline variables | 1.30 (1.18–1.42) | <.001 | 1.17 (1.09–1.27) | <.001 |
| Weighted models | ||||
| IPTW | 1.25 (1.17–1.43) | <.001 | 1.20 (1.14–1.27) | <.001 |
| MSM estimates | 1.67 (1.54–1.81) | <.001 | 1.28 (1.19–1.37) | <.001 |
| Subgroup analysis | P-value for interaction | P-value for interaction | ||
| Dementia severity | ||||
| Mild | 1.71 (1.53–1.90) | 0.40 | 1.31 (1.21–143) | 0.21 |
| Moderate | 1.91 (1.67–2.21) | 1.36 (1.16–1.60) | ||
| Severe | 1.42 (1.03–1.95) | 1.53 (0.97–2.40) | ||
| Use of prescription pain medication | ||||
| Yes | 1.56 (1.41–1.72) | 0.03 | 1.26 (1.16–1.37) | 0.30 |
| No | 1.90 (1.64–2.12) | 1.38 (1.18–1.62) | ||
| Use of pain management | ||||
| Yes | 1.54 (1.40–1.69) | 0.02 | 1.20 (1.11–1.30) | <.001 |
| No | 1.98 (1.65–2.37) | 1.76 (1.48–2.10) | ||
Abbreviations: ADRD, Alzheimer disease and related dementia; CI, confidence interval; IPTW, inverse probability of treatment (or exposure) weight; MSM, marginal structural modeling.