title: Effect of Pain and Mild Cognitive Impairment on Mobility.
abstract: OBJECTIVE
  To examine the effect of pain and mild cognitive impairment (MCI)-together and separately-on performance-based and self-reported mobility outcomes in older adults in primary care with mild to moderate self-reported mobility limitations.
  
  
  METHODS
  Cross-sectional analysis.
  
  
  METHODS
  Academic community outpatient clinic.
  
  
  METHODS
  Individuals aged 65 and older in primary care enrolled in the Boston Rehabilitative Impairment Study in the Elderly who were at risk of mobility decline (N=430).
  
  
  METHODS
  Participants with an average score greater than three on the Brief Pain Inventory (BPI) were defined as having pain. MCI was defined using age-adjusted scores on a neuropsychological battery. Multivariable linear regression models assessed associations between pain and MCI, together and separately, and mobility performance (habitual gait speed, Short Physical Performance Battery), and self-reports of function and disability in various day-to-day activities (Late Life Function and Disability Instrument).
  
  
  RESULTS
  The prevalence of pain was 34% and of MCI was 42%; 17% had pain only, 25% had MCI only, 17% had pain and MCI, and 41% had neither. Participants with pain and MCI performed significantly worse than all others on all mobility outcomes (P<.001). Participants with MCI only or pain only also performed significantly worse on all mobility outcomes than those with neither (P<.001).
  
  
  CONCLUSIONS
  Mild to moderate pain and MCI were independently associated with poor mobility, and the presence of both comorbidities was associated with the poorest status. Primary care practitioners who encounter older adults in need of mobility rehabilitation should consider screening them for pain and MCI to better inform subsequent therapeutic interventions.
authors.affiliation: Spaulding Rehabilitation Hospital, Boston, Massachusetts.|Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.|Touro University California College of Osteopathic Medicine, Vallejo, California.
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Schepker
authors.affiliation: Department of Nursing, University of Massachusetts Boston, Boston, Massachusetts.|Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
authors.forename: Suzanne G
authors.initials: SG
authors.lastname: Leveille
authors.affiliation: Spaulding Rehabilitation Hospital, Boston, Massachusetts.|Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.
authors.forename: Mette M
authors.initials: MM
authors.lastname: Pedersen
authors.affiliation: Spaulding Rehabilitation Hospital, Boston, Massachusetts.|Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.|School of Public Health, Boston University, Boston, Massachusetts.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Ward
authors.affiliation: Spaulding Rehabilitation Hospital, Boston, Massachusetts.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Kurlinski
authors.affiliation: Psychology Service, VA Boston Healthcare System, Boston, Massachusetts.|Department of Psychiatry, School of Medicine, Boston University, Boston, Massachusetts.
authors.forename: Laura
authors.initials: L
authors.lastname: Grande
authors.affiliation: Spaulding Rehabilitation Hospital, Boston, Massachusetts.
authors.forename: Dan K
authors.initials: DK
authors.lastname: Kiely
authors.affiliation: Spaulding Rehabilitation Hospital, Boston, Massachusetts.|Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.|New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts.
authors.forename: Jonathan F
authors.initials: JF
authors.lastname: Bean
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000503:physiopathology* / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D009483:Neuropsychological Tests; D010146:Pain / Q000175:diagnosis / Q000503:physiopathology* / Q000534:rehabilitation; D010147:Pain Measurement; D011446:Prospective Studies
keywords: aged; cognition; mobility; pain