title: Relationship between persistent pain and 5-year mortality: a population-based prospective cohort study.
abstract: OBJECTIVE
  To assess the association between self-reported noncancer pain and 5-year mortality.
  
  
  METHODS
  Cohort.
  
  
  METHODS
  Community-dwelling older adults.
  
  
  METHODS
  Canadian Study of Health and Aging 1996 wave.
  
  
  METHODS
  Registrar of Vital Statistics-established 5-year mortality. Noncancer pain was assessed using the 5-point verbal descriptor scale, dichotomized into no or very mild versus moderate, severe, or very severe pain. Frailty was the accumulation of health deficits. Cognitive status (Modified Mini-Mental State Examination) and depressed mood (five-item mental health screening questionnaire) were also assessed. Multivariable logistic regression and Cox proportional hazards were used to analyze the relationship between pain and 5-year mortality.
  
  
  RESULTS
  Of 5,703 participants, 4,694 (82.3%) had complete data for analysis; 1,663 of these (35.4%) reported moderate, severe, or very severe pain, and 1,343 (28.6%) had died at 5-year follow-up. Four hundred ninety-six of those who died (29.8%) reported moderate, severe, or very severe pain and 847 (27.9%) no or very mild pain. Multivariate logistic analysis found that individuals with moderate, severe, or very severe pain had lower odds of 5-year mortality than those with no or very mild pain (odds ratio=0.78, 95% confidence interval (CI)=0.66-0.92; P<.001). The risk of death was lower in persons reporting moderate or greater pain than in those with no or very mild pain (HR=0.85, 95% CI=0.75-0.96; P=.01). An interaction between pain and sex explained this effect. Men with pain were not significantly more likely than men without pain to die (HR=1.00, 95% CI=0.84-1.19; P=.99), whereas women without pain (HR=0.54, 95% CI=0.47-0.63; P<0.01) and women with pain (HR=0.40; CI=0.33-0.47; P<.01) had less risk of death than men without and with pain, respectively.
  
  
  CONCLUSIONS
  Older women with pain were less likely to die within 5 years than older women without pain, men in pain, or men without pain.
authors: Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, Illinois.
authors: Joseph W
authors: JW
authors: Shega
authors: Division of Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors: Melissa
authors: M
authors: Andrew
authors: Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, Illinois.
authors: Ashwin
authors: A
authors: Kotwal
authors: Division of Health Care Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Atlanta, Georgia.|Department of Pharmacy Administration, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois.
authors: Denys T
authors: DT
authors: Lau
authors: College of Nursing, University of Iowa, Iowa City, Iowa.
authors: Keela
authors: K
authors: Herr
authors: School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
authors: Mary
authors: M
authors: Ersek
authors: Geriatric Research, Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennslvania.|Department of Medicine, University of Pittsburgh, Pittsburgh, Pennslvania.|Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennslvania.|Department of Anesthesiology, University of Pittsburgh, Pittsburgh, Pennslvania.
authors: Debra K
authors: DK
authors: Weiner
authors: Section of General Internal Medicine, University of Chicago, Chicago, Illinois.
authors: Marshall H
authors: MH
authors: Chin
authors: Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, Illinois.|Section ofHematology and Oncology, University of Chicago, Chicago, Illinois.
authors: William
authors: W
authors: Dale
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D010146:Pain / Q000401:mortality*; D010147:Pain Measurement; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: mortality; older adult; pain