title: Pain at multiple body sites and health-related quality of life in older adults: results from the North Staffordshire Osteoarthritis Project.
abstract: OBJECTIVE
  Number of pain sites (NPS) is a potentially important marker of health-related quality of life (HRQoL) but remains unexplored in older people. This cross-sectional study investigated whether, in older people including the oldest old, NPS was independently associated with poorer mental and physical HRQoL and if the association was moderated by age.
  
  
  METHODS
  A postal questionnaire sent to a population sample of adults aged ≥50 years in North Staffordshire, UK, included the 12-item Short Form Health Survey (SF-12) mental component summary (MCS) and physical component summary (PCS), a blank body pain manikin, socio-demographic, health behaviour and morbidity questions. Participants shaded sites of pain lasting ≥1 day in the past 4 weeks on the manikin. OA consultation data were obtained for participants consenting to medical records review.
  
  
  RESULTS
  A total of 13 986 individuals (adjusted response 70.6%) completed a questionnaire, of which 12 408 provided complete pain data. The median NPS reported was 4 [interquartile range (IQR) 0-8]. General linear models showed that an increasing NPS was significantly associated with poorer MCS (β = -0.43, 95% CI -0.46, -0.40) and PCS (β = -0.87, 95% CI -0.90, -0.84). Adjustment for covariates attenuated the associations but they remained significant (
  β = -0.28, 95% CI -0.31, -0.24; PCS: β = -0.63, 95% CI -0.66, -0.59). The association between NPS and MCS or PCS was moderated by age, but the strongest associations were not in the oldest old.
  
  
  CONCLUSIONS
  NPS appears to be a potentially modifiable target for improving physical and mental HRQoL in older people. Future analyses should investigate the influence of NPS on HRQoL over time in older people.
authors.affiliation: Research Institute for Primary Care & Health Sciences and School of Computing and Mathematics, Keele University, Keele, UK r.lacey@keele.ac.uk.
authors.forename: Rosie J
authors.initials: RJ
authors.lastname: Lacey
authors.affiliation: Research Institute for Primary Care & Health Sciences and School of Computing and Mathematics, Keele University, Keele, UK Research Institute for Primary Care & Health Sciences and School of Computing and Mathematics, Keele University, Keele, UK.
authors.forename: John
authors.initials: J
authors.lastname: Belcher
authors.affiliation: Research Institute for Primary Care & Health Sciences and School of Computing and Mathematics, Keele University, Keele, UK.
authors.forename: Trishna
authors.initials: T
authors.lastname: Rathod
authors.affiliation: Research Institute for Primary Care & Health Sciences and School of Computing and Mathematics, Keele University, Keele, UK.
authors.forename: Ross
authors.initials: R
authors.lastname: Wilkie
authors.affiliation: Research Institute for Primary Care & Health Sciences and School of Computing and Mathematics, Keele University, Keele, UK.
authors.forename: Elaine
authors.initials: E
authors.lastname: Thomas
authors.affiliation: Research Institute for Primary Care & Health Sciences and School of Computing and Mathematics, Keele University, Keele, UK.
authors.forename: John
authors.initials: J
authors.lastname: McBeth
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D010146:Pain / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D011159:Population Surveillance / Q000379:methods*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
keywords: aged; cross-sectional survey; health-related quality of life; mental health; multisite pain; pain sites; physical health