Identifying the activities affected by chronic nonmalignant pain in older veterans receiving primary care.
OBJECTIVE
To identify the specific types of activities affected by chronic pain in older persons and the extent to which older individuals modify, perform less frequently, or terminate activities because of pain.


METHODS
Cross-sectional survey.


METHODS
Primary care practice at a Veterans Affairs Medical Center in New England.


METHODS
Two hundred forty-four patients (aged 65-90) with chronic nonmalignant pain.


METHODS
Open-ended questions were used to identify the activities affected by pain; participants' responses were subsequently organized into distinct categories (e.g., climbing stairs under higher-order physical activities and going out to dinner under social/recreational activities). Participants were also asked to indicate whether they had modified, performed less frequently, or terminated these activities because of pain.


RESULTS
Participants had a mean age+/-standard deviation of 75.4+/-5.2, were mostly male (84%), and had an average pain intensity score of 6.2+/-1.9 on a 0- to 10-scale. Two hundred three participants (83%) reported that pain affected one or more higher-order physical activities, and the corresponding percentages for the categories of social/recreational activities, instrumental activities of daily living, and basic activities of daily living were 74%, 57%, and 3%, respectively. The proportions of participants who modified, performed less frequently, or terminated one or more activities because of pain were 71%, 69%, and 22%, respectively.


CONCLUSIONS
Assessing the effects of chronic pain across multiple functional domains is indicated in older primary care patients, particularly higher-order physical and social/recreational activities. Inquiring about whether the activities are modified, reduced, or terminated may also help to expand understanding of pain-related disability in older persons.
Duong
Bao D
BD
Division of Emergency Medicine, Stanford-Kaiser Emergency Medicine Residency Program, Stanford University, Palo Alto, California, USA.
Kerns
Robert D
RD
Towle
Virginia
V
Reid
M Carrington
MC
D000203:Activities of Daily Living; D000368:Aged; D002908:Chronic Disease; D003237:Connecticut; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008297:Male; D010146:Pain; D011320:Primary Health Care; D014728:Veterans / Q000706:statistics & numerical data