Lynn R Gauthier1,2, Robert H Dworkin3, David Warr4,5, Rebecca Pillai Riddell6,7,8, Alison K Macpherson1, Gary Rodin2,5,7, Camilla Zimmermann2,5,7, S Lawrence Librach9,10, Malcolm Moore11, Frances A Shepherd4,5, Lucia Gagliese1,2,12,7,10. 1. School of Kinesiology and Health Science. 2. Department of Supportive Care. 3. Departments of Anesthesiology and Neurology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. 4. Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre. 5. Department of Medicine. 6. Department of Psychology, York University, Toronto, Ontario, Canada. 7. Department of Psychiatry. 8. Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada. 9. Family and Community Medicine, Division of Palliative Care, University of Toronto, Toronto, Ontario, Canada. 10. Mount Sinai Hospital, Toronto, Ontario, Canada. 11. British Columbia Cancer Agency, Vancouver, British Columbia, Canada. 12. Department of Anesthesia, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Abstract
Objective: Age-related patterns in cancer pain remain equivocal. Most studies ignore heterogeneity across multiple domains of well-being, and the potential role of physical (PH) and mental health (MH) quality of life (QOL) in these age-related patterns is unknown. We investigated the relationships between age and cancer pain intensity, qualities, and interference, and physical and psychosocial adaptation and the interaction between age and PH and MH QOL on pain and adaptation to cancer pain. Design: In this cross-sectional study, 244 patients with advanced cancer and pain completed measures of pain, QOL, physical function, and psychosocial well-being. Pearson's correlations and ANOVAs assessed relationships between age and demographic and clinical factors, pain, and physical and psychosocial measures. Regression models tested the role of age and its interaction with PH and MH QOL on pain and physical and psychosocial adaptation. Results: Older age was associated with a lower likelihood of receiving an opioid prescription, greater likelihood of having comorbidities, and worse functional status. When we did not account for these factors, age was not associated with pain and most adaptation indices. When we did account for these factors and PH QOL, older age was associated with lower non-neuropathic and neuropathic pain and several indices of psychosocial adaptation. Most interestingly, older age was associated with lower non-neuropathic pain among those with high, but not low, MH QOL. Conclusions: This study addresses knowledge gaps about factors underlying age-related patterns in cancer pain. Impaired MH QOL may be a proxy for age-related patterns in cancer pain. Summary: This study investigated age-related patterns in the experience of cancer pain and the role of quality of life in resilience and vulnerability to pain and adaptation to pain. Older age is associated with lower non-neuropathic pain among those with high, but not low, mental health quality of life, suggesting that impaired mental health quality of life is an important indicator of vulnerability to multidimensional pain outcomes.
Objective: Age-related patterns in cancer pain remain equivocal. Most studies ignore heterogeneity across multiple domains of well-being, and the potential role of physical (PH) and mental health (MH) quality of life (QOL) in these age-related patterns is unknown. We investigated the relationships between age and cancer pain intensity, qualities, and interference, and physical and psychosocial adaptation and the interaction between age and PH and MH QOL on pain and adaptation to cancer pain. Design: In this cross-sectional study, 244 patients with advanced cancer and pain completed measures of pain, QOL, physical function, and psychosocial well-being. Pearson's correlations and ANOVAs assessed relationships between age and demographic and clinical factors, pain, and physical and psychosocial measures. Regression models tested the role of age and its interaction with PH and MH QOL on pain and physical and psychosocial adaptation. Results: Older age was associated with a lower likelihood of receiving an opioid prescription, greater likelihood of having comorbidities, and worse functional status. When we did not account for these factors, age was not associated with pain and most adaptation indices. When we did account for these factors and PH QOL, older age was associated with lower non-neuropathic and neuropathic pain and several indices of psychosocial adaptation. Most interestingly, older age was associated with lower non-neuropathic pain among those with high, but not low, MH QOL. Conclusions: This study addresses knowledge gaps about factors underlying age-related patterns in cancer pain. Impaired MH QOL may be a proxy for age-related patterns in cancer pain. Summary: This study investigated age-related patterns in the experience of cancer pain and the role of quality of life in resilience and vulnerability to pain and adaptation to pain. Older age is associated with lower non-neuropathic pain among those with high, but not low, mental health quality of life, suggesting that impaired mental health quality of life is an important indicator of vulnerability to multidimensional pain outcomes.
Authors: Saunjoo L Yoon; Lisa Scarton; Laurie Duckworth; Yingwei Yao; Miriam O Ezenwa; Marie L Suarez; Robert E Molokie; Diana J Wilkie Journal: J Geriatr Oncol Date: 2021-05-07 Impact factor: 3.929