title: Association Between Pain and Functional Independence in Older Adults During and After Admission to Rehabilitation After an Acute Illness or Injury.
abstract: OBJECTIVE
  To investigate the association between pain and functional independence in older adults during and after admission to rehabilitation after an acute illness or injury.
  
  
  METHODS
  Prospective, observational cohort study.
  
  
  METHODS
  One community and one Veterans Affairs rehabilitation center.
  
  
  METHODS
  Individuals aged 65 and older admitted for rehabilitation after an acute illness or injury (postacute rehabilitation) (N = 245; mean age 80.6, 72% male)).
  
  
  METHODS
  Pain was assessed using the Geriatric Pain Measure (GPM, score 0-100). Functional independence was measured using the motor component of the Functional Independence Measure (mFIM, score 13-91). Both scores were obtained at admission; discharge; and 3-, 6-, and 9-month follow-up. In bivariate analyses, discharge GPM and persistent pain (lasting >3 months) were evaluated as predictors of mFIM score at 9 months. Applying a multilevel modeling (MLM) approach, individual deviations in GPM scores were used to predict variations in mFIM.
  
  
  RESULTS
  At admission, 210 participants (87.9%) reported pain (16.3% mild (GPM<30); 49.3% moderate (GPM: 30-69); 22.1% severe (GPM>70)); 21.3% reported persistent pain after discharge. The bivariate analyses did not find statistically significant associations between discharge GPM or persistent pain and mFIM score at 9 months, but in the MLM analysis, deviations in GPM were significant predictors of deviations in mFIM score, suggesting that, when individuals experienced above-average levels of pain (GPM > their personal mean GPM), they also experienced worse functional independence (mFIM < their personal mean mFIM).
  
  
  CONCLUSIONS
  Twenty-one percent of older adults undergoing postacute rehabilitation reported persistent pain after discharge from rehabilitation. The bivariate analysis did not find association between pain and functional independence, but MLM analysis showed that, when participants experienced more pain than their average, they had less functional independence.
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, California.|Department of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Rodriguez
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, California.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Dzierzewski
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, California.
authors.forename: Constance H
authors.initials: CH
authors.lastname: Fung
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Stella
authors.initials: S
authors.lastname: Jouldjian
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Karen R
authors.initials: KR
authors.lastname: Josephson
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Mitchell
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Yeonsu
authors.initials: Y
authors.lastname: Song
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, California.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Martin
authors.affiliation: Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, California.
authors.forename: Cathy A
authors.initials: CA
authors.lastname: Alessi
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D064887:Observational Studies as Topic; D010146:Pain / Q000503:physiopathology / Q000534:rehabilitation*; D011446:Prospective Studies
keywords: aged; functional independence; pain; rehabilitation