title: Pain quality descriptors in community-dwelling older adults with nonmalignant pain.
abstract: This study aimed to characterize the prevalence of various pain qualities in older adults with chronic nonmalignant pain and determine the association of pain quality to other pain characteristics namely: severity, interference, distribution, and pain-associated conditions. In the population-based MOBILIZE Boston Study, 560 participants aged ≥70 years reported chronic pain in the baseline assessment, which included a home interview and clinic exam. Pain quality was assessed using a modified version of the McGill Pain Questionnaire (MPQ) consisting of 20 descriptors from which 3 categories were derived: cognitive/affective, sensory, and neuropathic. Presence of ≥2 pain-associated conditions was significantly associated with 18 of the 20 pain quality descriptors. Sensory descriptors were endorsed by nearly all older adults with chronic pain (93%), followed by cognitive/affective (83.4%) and neuropathic descriptors (68.6%). Neuropathic descriptors were associated with the greatest number of pain-associated conditions including osteoarthritis of the hand and knee. More than half of participants (59%) endorsed descriptors in all 3 categories and had more severe pain and interference, and multisite or widespread pain than those endorsing 1 or 2 categories. Strong associations were observed between pain quality and measures of pain severity, interference, and distribution (P < 0.0001). Findings from this study indicate that older adults have multiple pain-associated conditions that likely reflect multiple physiological mechanisms for pain. Linking pain qualities with other associated pain characteristics serve to develop a multidimensional approach to geriatric pain assessment. Future research is needed to investigate the physiological mechanisms responsible for the variability in pain qualities endorsed by older adults.
authors.affiliation: Group Health Research Institute, Seattle, WA, USA.
authors.forename: Manu
authors.initials: M
authors.lastname: Thakral
authors.affiliation: College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.
authors.forename: Ling
authors.initials: L
authors.lastname: Shi
authors.affiliation: College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.
authors.forename: Janice B
authors.initials: JB
authors.lastname: Foust
authors.affiliation: Center for Pain Research on Impact, Measurement and Effectiveness, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Kushang V
authors.initials: KV
authors.lastname: Patel
authors.affiliation: Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.|Division of Rheumatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.|Departments of Medicine and Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Shmerling
authors.affiliation: Spaulding Rehabilitation Hospital, Boston, MA, USA.|Departments of Medicine and Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
authors.forename: Jonathan F
authors.initials: JF
authors.lastname: Bean
authors.affiliation: College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.|Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.|Departments of Medicine and Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
authors.forename: Suzanne G
authors.initials: SG
authors.lastname: Leveille
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015331:Cohort Studies; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D010146:Pain / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods*; D058748:Pain Perception / Q000502:physiology*