Guusje van der Leeuw1,2, Suzanne G Leveille1,3, Zhiyong Dong3, Ling Shi1, Daniel Habtemariam4, William Milberg5,6, Jeffrey M Hausdorff7,8,9, Laura Grande10,11, Peggy Gagnon4, Robert R McLean3,12, Jonathan F Bean5,13,14. 1. College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts. 2. Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. 3. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts. 4. Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts. 5. New England Geriatric, Research, Education and Clinical Center, Veterans Affairs Boston Healthcare System, Boston, Massachusetts. 6. Department of Psychiatry, School of Medicine, Harvard University, Boston, Massachusetts. 7. Center for Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 8. Department of Physical Therapy, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel. 9. Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois. 10. Psychology Service, Veterans Affairs Boston Healthcare System, Boston, Massachusetts. 11. Department of Psychiatry, School of Medicine, Boston University, Boston, Massachusetts. 12. Department of Medicine, School of Medicine, Harvard University, Boston, Massachusetts. 13. Department of Physical Medicine and Rehabilitation, School of Medicine, Harvard University, Boston, Massachusetts. 14. Spaulding Rehabilitation Hospital, Boston, Massachusetts.
Abstract
OBJECTIVES: To examine the cross-sectional relationship between chronic pain and complex attention in a population of community-living older adults. DESIGN: Prospective cross-sectional cohort study. SETTING: Population-based Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study II. PARTICIPANTS: Individuals aged 71 to 101 (N=354). MEASUREMENTS: Chronic pain was measured using the pain severity and interference subscales of the Brief Pain Inventory. Four subscales of the Test of Everyday Attention were used to measure domains of attention switching and selective, sustained, and divided attention. RESULTS: Before and after multivariable adjustment, pain severity was associated with poorer scores on measures of selective and sustained attention. Pain interference scores also were significantly inversely associated with selective attention. CONCLUSION: Chronic pain is associated with poorer performance in selective and sustained attention in community-dwelling older adults. Further research is needed to determine whether effective pain management could lead to better attentional performance in older adults. Older adults who live with chronic pain, often undertreated, are potentially at risk of cognitive difficulties and related functional consequences.
OBJECTIVES: To examine the cross-sectional relationship between chronic pain and complex attention in a population of community-living older adults. DESIGN: Prospective cross-sectional cohort study. SETTING: Population-based Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study II. PARTICIPANTS: Individuals aged 71 to 101 (N=354). MEASUREMENTS: Chronic pain was measured using the pain severity and interference subscales of the Brief Pain Inventory. Four subscales of the Test of Everyday Attention were used to measure domains of attention switching and selective, sustained, and divided attention. RESULTS: Before and after multivariable adjustment, pain severity was associated with poorer scores on measures of selective and sustained attention. Pain interference scores also were significantly inversely associated with selective attention. CONCLUSION: Chronic pain is associated with poorer performance in selective and sustained attention in community-dwelling older adults. Further research is needed to determine whether effective pain management could lead to better attentional performance in older adults. Older adults who live with chronic pain, often undertreated, are potentially at risk of cognitive difficulties and related functional consequences.
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