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Woods SB, Roberson PNE, Booker Q, Wood BL, Booker SQ. Longitudinal Associations of Family Relationship Quality With Chronic Pain Incidence and Persistence Among Aging African Americans. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae064. [PMID: 38767217 PMCID: PMC11161900 DOI: 10.1093/geronb/gbae064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVES This study examines how family relationships convey risk or resilience for pain outcomes for aging African Americans, and to replicate and extend analyses across 2 nationally representative studies of aging health. METHODS African American participants in Midlife in the United States (MIDUS, N = 755) and the Health and Retirement Study (HRS, N = 2,585) self-reported chronic pain status at 2006 waves and then again 10 years later. Logistic regression was used to estimate the odds of pain incidence and persistence explained by family, intimate partner, and parent-child strain and support, as well as average support and average strain across relationships. RESULTS On average, MIDUS participants were younger (M = 52.35, SD = 12.06; 62.1% female) than HRS (M = 66.65, SD = 10.92; 63.7% female). Family support and average support were linked to decreased odds of pain incidence in MIDUS, but only when tested without accounting for strain, whereas parent-child strain was a risk factor for pain incidence in HRS, as was average strain. Family support protected against pain persistence in MIDUS, whereas average support was linked to reduced odds of pain persisting in HRS. DISCUSSION Chronic pain outcomes are worse for African Americans for a number of reasons, but parent-child strain may contribute to the risk of new pain developing over time for older adults. Conversely, family support may offer a protective benefit for pain incidence and persistence among aging African Americans. Findings implicate family relationships as a potential target of pain management interventions.
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Affiliation(s)
- Sarah B Woods
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Quiera Booker
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Beatrice L Wood
- Departments of Psychiatry and Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Staja Q Booker
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
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Jensen A, Pirouzifard M, Lindström M. Arts and culture engagement and mortality: A population-based prospective cohort study. Scand J Public Health 2024; 52:511-520. [PMID: 37086102 PMCID: PMC11179309 DOI: 10.1177/14034948231165853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 02/16/2023] [Accepted: 03/09/2023] [Indexed: 04/23/2023]
Abstract
AIMS The aim of this study was to investigate associations between having visited the theatre/cinema and an arts exhibition during the past year and all-cause, cardiovascular disease (CVD), cancer and other-cause mortality. METHODS The 2008 public health postal survey in Scania, Sweden, was distributed to a stratified random sample of the adult population (18-80 years old). The participation rate was 54.1%, and 25,420 participants were included in the present study. The baseline 2008 survey data were linked to cause-of-death register data to create a prospective cohort with 8.3-year follow-up. Associations between visit to the theatre/cinema, visit to an arts exhibition and mortality were investigated in survival (Cox) regression models. RESULTS Just over a quarter (26.5%) had visited both the theatre/cinema and an arts exhibition during the past year, 36.6% only the theatre/cinema, 4.9% only an arts exhibition and 32% neither of the two. Not visiting the theatre/cinema during the past year was associated with higher all-cause and CVD mortality. Not visiting an arts exhibition was associated with higher all-cause and other-cause mortality. The combination of having visited neither the theatre/cinema nor an arts exhibition during the past year was associated with higher all-cause, CVD and other-cause mortality. CONCLUSIONS There is an association between attending arts and culture activities and a reduced risk of CVD and other-cause mortality but not cancer mortality, although model imperfections are possible.
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Affiliation(s)
- Anita Jensen
- Social Medicine and Health Policy, Department of Clinical Sciences and Centre for Primary Health Care Research, Lund University and Region Skåne, Sweden
| | - Mirnabi Pirouzifard
- Social Medicine and Health Policy, Department of Clinical Sciences and Centre for Primary Health Care Research, Lund University and Region Skåne, Sweden
| | - Martin Lindström
- Social Medicine and Health Policy, Department of Clinical Sciences and Centre for Primary Health Care Research, Lund University and Region Skåne, Sweden
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Huang G, Wabe N, Raban MZ, Silva SSM, Seaman K, Nguyen AD, Meulenbroeks I, Westbrook JI. The relationship between participation in leisure activities and incidence of falls in residential aged care. PLoS One 2024; 19:e0302678. [PMID: 38662707 PMCID: PMC11045105 DOI: 10.1371/journal.pone.0302678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/06/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Active engagement in leisure activities has positive effects on individuals' health outcomes and social functioning; however, there is limited understanding of the link between participation in leisure activities, particularly non-exercise activities, and falls in older adults. This study aimed to determine the relationship between participation in leisure activities and the incidence of falls, and the variation of this relationship by dementia status in residential aged care facilities (RACFs). METHODS A retrospective longitudinal cohort study utilising routinely collected data (January 2021-August 2022) from 25 RACFs in Sydney, Australia, was conducted. The cohort included 3,024 older permanent residents (1,493 with dementia and 1,531 without) aged ≥65 and with a stay of ≥1 week. The level of participation in leisure activities was measured using the number of leisure activities per 1,000 resident days and divided into quartiles. Outcome measures were the incidence rate of all falls and injurious falls (i.e., number of falls per 1,000 resident days). We used multilevel negative binary regression to examine the relationship between leisure participation and fall incidence. RESULTS For the whole sample, leisure participation was significantly inversely associated with the incidence rate of all falls and injurious falls. For example, residents in the high leisure participation group were 26% less likely to experience a fall compared to those in the low leisure participation group after controlling for confounders (incidence rate ratio = 0.74, 95% confidence interval = 0.60, 0.91). Such inverse relationship was observed in both exercise and non-exercise activities and was stronger among residents without dementia. CONCLUSIONS Leisure participation is associated with a lower rate of falls, a key quality indicator by which RACFs are benchmarked and funded in Australia and many other countries. More recognition and attention are needed for the currently underfunded leisure activities in RACFs in future funding arrangement.
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Affiliation(s)
- Guogui Huang
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Nasir Wabe
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Magdalena Z. Raban
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - S. Sandun Malpriya Silva
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Karla Seaman
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Amy D. Nguyen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- St Vincent’s Clinical School, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Isabelle Meulenbroeks
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Johanna I. Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Koren Y, Kim S, Song Q, Leveille S. Physical Activity, Social Participation, and Pain Outcomes Among Community-Dwelling Older Adults. Pain Manag Nurs 2024; 25:137-144. [PMID: 38151363 DOI: 10.1016/j.pmn.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/12/2023] [Accepted: 10/12/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Little is known regarding the effect of social participation (SP) and physical activity (PA) on pain outcomes among community-dwelling older adults in the United States. AIMS To determine whether SP and PA are associated with pain outcomes (bothersome pain and number of pain sites). DESIGN Guided by the biopsychosocial model of chronic pain for older adults, we analyzed data from 7,187 community dwelling participants in the National Health and Aging Trends Study. In cross-sectional analyses, we utilized logistic and negative binomial regressions. METHODS We prospectively assessed the association between SP/ PA and new or worsening pain from baseline (2011) to 2021 using a discrete time survival analysis by logistic regression, controlling for sociodemographic and health characteristics. RESULTS At baseline, participation in 5 SP activities per month versus no activities, and performing any PA compared with no PA were significantly associated with lower likelihood of bothersome pain. Although SP and PA were associated with reporting fewer pain sites at baseline, SP was not associated with developing new or worsening pain, prospectively. However, walking and vigorous exercise compared with no PA was significantly associated with a 10% lower risk of developing new or worsening pain (adj odds ratio 0.90, 95% confidence interval [CI] 0.82-0.98). CONCLUSIONS Physical activity but not social participation may protect against development of new or worsening pain. More research is needed to determine whether social activity can be beneficial for pain prevention and management. Efforts to promote physical activity among older adults may reduce risk of new or worsening pain.
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Affiliation(s)
- Yael Koren
- Robert and Donna Manning College of Nursing & Health Sciences, University of Massachusetts Boston, Boston, Massachusetts.
| | - Sun Kim
- Robert and Donna Manning College of Nursing & Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
| | - Qian Song
- Robert and Donna Manning College of Nursing & Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
| | - Suzanne Leveille
- Robert and Donna Manning College of Nursing & Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
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Miki T, Cooray U, Kanai M, Hagiwara Y, Ikeda T. Cultural engagement and prevalence of pain in socially isolated older people: a longitudinal modified treatment policy approach. EClinicalMedicine 2024; 69:102477. [PMID: 38356730 PMCID: PMC10864863 DOI: 10.1016/j.eclinm.2024.102477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/16/2024] Open
Abstract
Background It remains uncertain whether cultural engagement positively influences the reduction of pain risk, particularly depending on the social isolation status. The aim of this study was to examine the impact of cultural engagement on the reduction of pain prevalence over a 6-year follow-up period among older people, particularly those experiencing different dimensions of social isolation. Methods This study was a prospective longitudinal study. We analysed the English Longitudinal Study of Ageing cohort, consisting of 6468 community-dwelling adults aged ≥50 years old who provided data in waves 6 (2012-2013), 7 (2014-2015), 8 (2016-2017), and 9 (2018-2019). Self-reported cultural engagement (going to museums, art galleries, exhibitions, the theatre, concerts, or the opera) measured in waves 6-8 was used as the exposure variable. Meanwhile self-reported moderate-to-severe pain in wave 9 was used as the outcome variable. Social isolation was considered in waves 6-8, and the possibility of effect modification was captured by assessing each component of the social isolation index: not married or cohabiting with a partner, fewer than monthly contact with children/other immediate family/friends, and not engaging in any organisations, religious groups, or committees. Findings The estimated pain prevalence was 29.2% (95% confidence interval, 28.1-30.3; reference) after adjusting for time-variant, time-invariant, and loss to follow-up factors. Cultural engagement led to a reduction in pain prevalence to 24.1% for all individuals, representing a decrease of 5.1% (95% confidence interval, 0.6-9.6; P-value, 0.03). In older people who were not married or cohabiting, cultural engagement resulted in a decrease in pain prevalence to 25.8%, a reduction of 3.4% (95% confidence interval, 0.4-6.4; P-value, 0.01). For those with less frequent contact with close family members, the pain prevalence decreased to 25.3%, a reduction of 3.9% (95% confidence interval, 0.2-7.6; P-value, 0.03). Meanwhile, other dimensions of social isolation did not show a significant reduction in pain prevalence. Interpretation Cultural engagement may help to reduce the risk of pain in socially isolated older adults. Those who were single or living alone and had less frequent contact with immediate family were particularly vulnerable. While cultural engagement might help certain socially isolated older people feel better, its effectiveness varies, highlighting the need for targeted interventions. Funding The Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number (22K17648, Ikeda).
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Affiliation(s)
- Takahiro Miki
- Insight Lab, PREVENT Inc., Aichi, Japan
- Graduate School of Rehabilitation Science, Saitama Prefectural University, Japan
| | - Upul Cooray
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Masashi Kanai
- Insight Lab, PREVENT Inc., Aichi, Japan
- Institute of Transdisciplinary Sciences for Innovation, Kanazawa University, Ishikawa, Japan
| | | | - Takaaki Ikeda
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
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Yang Y, Sims KD, Lane NE, Duchowny KA, Torres JM. Perceived Neighborhood Characteristics and Later-Life Pain Outcomes: Evidence From the Health and Retirement Study. J Aging Health 2024; 36:246-256. [PMID: 37349863 PMCID: PMC10739572 DOI: 10.1177/08982643231185382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Objectives: This study examines whether perceived neighborhood characteristics relate to pain outcomes among middle-aged and older adults. Methods: Data were from the Health and Retirement Study (2006-2014; n = 18,814). Perceived neighborhood characteristics were physical disorder, social cohesion, safety, and social ties. We fitted adjusted generalized estimating equation models to evaluate prevalence, incidence, and recovery of moderate-to-severe limiting pain 2 years later. Results: The mean age of our sample was 65.3 years; 54.6% were female and 24.2% reported moderate-to-severe limiting pain at baseline. Positive neighborhood characteristics were associated with low prevalence (e.g., prevalence ratio [PR]: .71 for disorder) and reduced incidence (e.g., PR: .63 for disorder) of moderate-to-severe limiting pain. Positive neighborhood characteristics were associated with a high recovery rate from moderate-to-severe limiting pain (e.g., PR = 1.15 for safety), though the 95% CIs for disorder and cohesion crossed the null. Discussion: Neighborhood characteristics may be important determinants in predicting pain in later life.
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Affiliation(s)
- Yulin Yang
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Kendra D. Sims
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Nancy E. Lane
- Center for Musculoskeletal Health, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Kate A. Duchowny
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Jacqueline M. Torres
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
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Suzuki Y, Suzuki T, Takagi M, Murakami M, Ikeda T. Bidirectional Longitudinal Association between Back Pain and Loneliness in Later Life: Evidence from English Longitudinal Study of Ageing. Ann Geriatr Med Res 2024; 28:27-35. [PMID: 38105012 PMCID: PMC10982446 DOI: 10.4235/agmr.23.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/12/2023] [Accepted: 10/28/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND This study examined the bidirectional and temporal-ordinal relationship between loneliness and back pain. METHODS Data from 7,730 participants in waves 6 (2012-2013), 7 (2014-2015), and 8 (2016-2017) of the national English Longitudinal Study of Ageing were analyzed. Back pain was graded on a scale of 0-10 (0, no discomfort; 10, unbearable pain). Loneliness was measured using the Revised University of California Los Angeles Loneliness Scale. A targeted minimum loss-based estimator was used to examine the bidirectional longitudinal associations between back pain and loneliness. RESULTS No loneliness in waves 6 and 7 (relative risk [RR]=0.76; 95% confidence interval [CI], 0.61-0.94), no loneliness in wave 6 but loneliness in wave 7 (RR=0.58; 95% CI, 0.50-0.68), and loneliness in wave 6 but not in wave 7 (RR=0.69; 95% CI, 0.57-0.86) were associated with significant risk reductions of back pain in wave 8 compared with the scenario of loneliness in waves 6 and 7. Mild back pain in wave 6 but moderate back pain (RR=0.55; 95% CI, 0.35-0.86) or severe back pain in wave 7 (RR=0.49; 95% CI, 0.34-0.72) showed a significant risk reduction of loneliness in wave 8 compared with severe back pain in waves 6 and 7. CONCLUSION Loneliness may be a risk factor for back pain, and back pain may be a risk factor for loneliness. The results of this study will inform the development of more effective interventions for loneliness and back pain.
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Affiliation(s)
- Yuta Suzuki
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
- Department of Orthopedic Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tomoto Suzuki
- Department of Orthopedic Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Michiaki Takagi
- Department of Orthopedic Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Masayasu Murakami
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
| | - Takaaki Ikeda
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
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Bone JK, Bu F, Sonke JK, Fancourt D. Leisure engagement in older age is related to objective and subjective experiences of aging. Nat Commun 2024; 15:1499. [PMID: 38374197 PMCID: PMC10876530 DOI: 10.1038/s41467-024-45877-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 02/07/2024] [Indexed: 02/21/2024] Open
Abstract
Leisure engagement has potential to slow health and functional decline in older age. However, the benefits of different leisure domains for different aspects of aging remains unclear. In 8771 older adults from the Health and Retirement Study (a longitudinal panel study), we measured engagement in physical, creative, cognitive, and community activities. Outcome-wide analyses used 23 aging experiences across seven domains eight years later (daily functioning, physical fitness, long-term physical health problems, heart health, weight, sleep, subjective perceptions of health). Physical activity was related to more positive experiences in all domains but heart health eight years later. Creative engagement was positively related to aging experiences in four domains longitudinally. Cognitive and community engagement were less consistently related to aging experiences. Physical and creative activities may influence important aging metrics, reducing age-related decline and keeping older adults functionally independent for longer, potentially limiting increasing healthcare costs.
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Affiliation(s)
- Jessica K Bone
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK.
| | - Feifei Bu
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK
| | - Jill K Sonke
- Center for Arts in Medicine, University of Florida, Gainesville, FL, USA
| | - Daisy Fancourt
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK
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Huber FA, Carpenter R, Goodin BR, Bruehl S, Karlson C, Rao U, Kinney K, Nag S, Morris MC. Physical activity, sitting time, and thermal quantitative sensory testing responses in African Americans. Pain Rep 2023; 8:e1118. [PMID: 38152687 PMCID: PMC10752487 DOI: 10.1097/pr9.0000000000001118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/29/2023] [Accepted: 10/09/2023] [Indexed: 12/29/2023] Open
Abstract
Introduction Prior research suggests that African Americans (AAs) have more frequent, intense, and debilitating pain and functional disability compared with non-Hispanic Whites (NHWs). Potential contributing factors to this disparity are physical activity and sedentary behavior, given that AAs are less physically active, and physical activity is associated with antinociception (whereas sedentary behavior is linked to pronociception). However, impact of these factors on pain processing has largely been unexplored in AAs, especially before chronic pain onset. Objective This study examined relationships between physical activity, sedentary behavior (sitting time), and laboratory measures of pain and pain modulation in adult AAs. These included heat pain threshold and tolerance, temporal summation of pain (TSP, a marker of central sensitization), and conditioned pain modulation (CPM, a marker of descending pain inhibition). Methods Multiple regressions were conducted to examine the effects of physical activity and sitting time on heat threshold and tolerance. Multilevel models were conducted to assess the relationship between physical activity, sitting time, and temporal summation of pain. Additional multilevel models were conducted to assess the relationship between physical activity, sitting time, and conditioned pain modulation. Results Higher level of physical activity, but not sitting time, was associated with reduced TSP slopes. Neither physical activity nor sitting time was associated with CPM slopes. No significant relationships between physical activity or sitting time and heat pain threshold or tolerance were detected. Conclusions These findings suggest that physical activity is associated with reduced TSP, an effect which may be driven by reduced spinal hyperexcitability in more active individuals. Thus, structural and individual interventions designed to increase physical activity in healthy, young AAs may be able to promote antinociceptive processes (ie, reduced TSP/reduced pain facilitation) potentially protective against chronic pain.
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Affiliation(s)
- Felicitas A. Huber
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Anesthesiology, Washington University Pain Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel Carpenter
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - Burel R. Goodin
- Department of Anesthesiology, Washington University Pain Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cynthia Karlson
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - Uma Rao
- University of California at Irvine, Irvine, CA, USA
- Children's Hospital of Orange County, Orange, CA, USA
| | - Kerry Kinney
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - Subodh Nag
- Department of Biochemistry, Cancer Biology, Neuroscience and Pharmacology, Meharry Medical College, TN, Nashville, USA
| | - Matthew C. Morris
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
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de C Williams AC. Pain: Behavioural expression and response in an evolutionary framework. Evol Med Public Health 2023; 11:429-437. [PMID: 38022798 PMCID: PMC10656790 DOI: 10.1093/emph/eoad038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
An evolutionary perspective offers insights into the major public health problem of chronic (persistent) pain; behaviours associated with it perpetuate both pain and disability. Pain is motivating, and pain-related behaviours promote recovery by immediate active or passive defence; subsequent protection of wounds; suppression of competing responses; energy conservation; vigilance to threat; and learned avoidance of associated cues. When these persist beyond healing, as in chronic pain, they are disabling. In mammals, facial and bodily expression of pain is visible and identifiable by others, while social context, including conspecifics' responses, modulate pain. Studies of responses to pain emphasize onlooker empathy, but people with chronic pain report feeling disbelieved and stigmatized. Observers frequently discount others' pain, best understood in terms of cheater detection-alertness to free riders that underpins the capacity for prosocial behaviours. These dynamics occur both in everyday life and in clinical encounters, providing an account of the adaptiveness of pain-related behaviours.
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Affiliation(s)
- Amanda C de C Williams
- Research Department of Clinical, Educational & Health Psychology, University College London, Gower St, London WC1E 6BT, UK
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11
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Ikeda T, Cooray U, Murakami M, Osaka K. Assessing the impacts of smoking cessation and resumption on back pain risk in later life. Eur J Pain 2023; 27:973-980. [PMID: 37231546 DOI: 10.1002/ejp.2139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/03/2023] [Accepted: 05/09/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND This study aimed to assess the impacts of smoking cessation and resumption over 4 years on the risk of back pain at the 6-year follow-up among older adults in England. METHODS We analysed 6467 men and women aged ≥50 years in the English Longitudinal Study of Aging. Self-reported smoking status, assessed in waves 4 (2008-2009) and 6 (2012-2013), was used as exposure for the study, whereas self-reported back pain of moderate or severe intensity, assessed in wave 7 (2014-2015), was used as the outcome. A targeted minimum loss-based estimator was used with longitudinal modified treatment policies to adjust for baseline and time-varying covariates. RESULTS Regarding the estimation of the effects of changes in smoking status on the risk of back pain, during the follow-up, individuals who resumed smoking within 4 years had a higher risk of back pain than those who avoided smoking for over 4 years, and the relative risk (RR) (95% confidence interval [CI]) was 1.536 (1.214-1.942). Regarding the estimation of effects of smoking cessation on the risk of back pain, smoking cessation over 4 years was associated with a significantly lower risk of back pain, as indicated by the originally observed data, and the RR (95% CI) was 0.955 (0.912-0.999). CONCLUSIONS Older adults who avoided smoking for over 4 years had a lower risk of back pain. However, those who resumed smoking within 4 years had a higher risk of back pain. SIGNIFICANCE Older adults who avoided smoking for over 4 years had a lower risk of back pain. However, those who resumed smoking within 4 years had a higher risk of back pain. Our study data suggest the importance of maintaining smoking cessation to reduce the risk of back pain in the older population.
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Affiliation(s)
- Takaaki Ikeda
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Upul Cooray
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Masayasu Murakami
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Lee SY, Kim JB, Lee JW, Woo AM, Kim CJ, Chung MY, Moon HS. A Quantitative Measure of Pain with Current Perception Threshold, Pain Equivalent Current, and Quantified Pain Degree: A Retrospective Study. J Clin Med 2023; 12:5476. [PMID: 37685543 PMCID: PMC10487999 DOI: 10.3390/jcm12175476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Background: As a subjective sensation, pain is difficult to evaluate objectively. The assessment of pain degree is largely dependent on subjective methods such as the numeric rating scale (NRS). The PainVisionTM system has recently been introduced as an objective pain degree measurement tool. The purpose of this study was to analyze correlations between the NRS and the current perception threshold (CPT), pain equivalent current (PEC), and quantified pain degree (QPD). Methods: Medical records of 398 subjects who visited the pain clinic in a university hospital from March 2017 to February 2019 were retrospectively reviewed. To evaluate the pain degree, NRS, CPT, PEC, and QPD were measured. Subjects were categorized into two groups: the Pain group (n = 355) and the No-pain group (n = 43). Results: The NRS showed a negative correlation with CPT (R = -0.10, p = 0.054) and a positive correlation with QPD (R = 0.13, p = 0.008). Among various diseases, only spinal disease patients showed a negative correlation between CPT and NRS (R = -0.22, p = 0.003). Additionally, there were significant differences in CPT and QPD between the Pain and No-pain groups (p = 0.005 and p = 0.002, respectively). Conclusions: CPT and QPD measured using the PainVisionTM system could be used to estimate pain intensity and the presence of pain. These parameters would be considered useful for predicting pain itself and its intensity.
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Affiliation(s)
| | | | | | | | | | | | - Ho Sik Moon
- Department of Anesthesiology and Pain Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea; (S.Y.L.); (J.B.K.); (J.W.L.); (A.M.W.); (C.J.K.); (M.Y.C.)
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13
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Zhu C, Walsh C, Zhou L, Zhang X. Latent Classification Analysis of Leisure Activities and Their Impact on ADL, IADL and Cognitive Ability of Older Adults Based on CLHLS (2008-2018). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1546. [PMID: 36674302 PMCID: PMC9864528 DOI: 10.3390/ijerph20021546] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/06/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
This study aimed to research the trajectory of leisure activity and the health status of older adults and analyze the effects of leisure activity on the health status of older adults. Based on the longitudinal data of CLHLS (2008-2018), the latent growth curve model (LGCM) was used; we found that the leisure activities (LA), activities of daily living (ADL) ability, instrumental activities of daily living (IADL) ability, and cognitive ability (COG) of older adults show a nonlinear downward trend over time. Furthermore, the panel binary regression analysis is used to find that leisure activities have significant inhibitory effects on ADL disorder, IADL disorder, and cognitive impairment in the older population. In addition, by using latent profile analysis (LPA), the older population is classified into three groups according to the homogeneity of the older adults' choice of leisure activities, namely the types of relaxation, entertainment, and intellectual-learning, respectively. Based on the classification results, the analysis of one-way ANOVA shows that the rates of ADL disorder, IADL disorder, and cognitive impairment of older adults with different types are significantly different. Moreover, the inhibitory effect of leisure activities on the rate of ADL disorder, IADL disorder, and cognitive impairment of older adults is more significant in the middle-aged and high-aged groups. Therefore, older adults should be encouraged to increase leisure activities, especially those who are middle-aged and high-aged.
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Affiliation(s)
- Change Zhu
- Department of Management, Jiangsu University, 301 Xuefu Road, Jingkou District, Zhenjiang 212001, China
- Faculty of Social Work, University of Calgary, 2500 University Drive NW Calgary, Calgary, AB T2N 1N4, Canada
| | - Christine Walsh
- Faculty of Social Work, University of Calgary, 2500 University Drive NW Calgary, Calgary, AB T2N 1N4, Canada
| | - Lulin Zhou
- Department of Management, Jiangsu University, 301 Xuefu Road, Jingkou District, Zhenjiang 212001, China
| | - Xinjie Zhang
- Department of Management, Jiangsu University, 301 Xuefu Road, Jingkou District, Zhenjiang 212001, China
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14
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Feldman DE, Nahin RL. Disability Among Persons With Chronic Severe Back Pain: Results From a Nationally Representative Population-based Sample. THE JOURNAL OF PAIN 2022; 23:2144-2154. [PMID: 36096352 DOI: 10.1016/j.jpain.2022.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/28/2022] [Accepted: 07/31/2022] [Indexed: 01/04/2023]
Abstract
We evaluated the association between the chronic severe back pain with disability and participation, in U.S. Adults using data from the US 2019 National Health Interview Survey. In our sample of 2,925 adults (weighted n: 20,468,134) who reported having chronic severe back pain, 60% reported mobility disability, 60% had work limitations, 34% were limited for social participation and 16% had self-care limitations. Older age (65+) was associated with mobility difficulties (OR 1.99, 95% CI 1.28,6.09) and work limitation (OR 2.21, 95% CI 1.61,3.05). Lower socioeconomic status was associated with increasing odds of disability across the 4 categories. Being obese was only associated with mobility difficulties (OR 1.95, 95% CI 1.41,2.71), while not working in the past week was associated with difficulties in mobility (OR 3.55, 95% CI 2.64,4.75), self-care (OR 3.34, 95% CI 2.20,5.08), and social participation (OR 3.20, 95% CI 2.13,4.80). Comorbidities were highly associated with limitations in all 4 categories. Those deeming their ability to manage their pain ineffective were twice as likely to have limitations in self-care, social and work participation but not mobility. Identifying factors associated with disability and limitation may help target appropriate management for persons with chronic pain at high risk for disability. PERSPECTIVE: We evaluated the association between the chronic severe back pain with disability and participation, in a representative sample of Americans. Identifying factors associated with a likelihood of disability may help target appropriate pain management for persons at high risk for disability due to chronic severe back pain.
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Affiliation(s)
- Debbie Ehrmann Feldman
- School of Rehabilitation, Faculty of Medicine, Physiotherapy Program and School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Centre for interdisciplinary research in rehabilitation, CReSP: Center for Research in Public Health, Université de Montréal, Montreal, Canada.
| | - Richard L Nahin
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland
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15
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Marques RLDS, Rezende ATDO, Junger AL, Noll M, de Oliveira C, Silveira EA. What is the relationship between physical activity and chronic pain in older adults? A systematic review and meta-analysis protocol. BMJ Open 2022; 12:e062566. [PMID: 36414314 PMCID: PMC9684997 DOI: 10.1136/bmjopen-2022-062566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Chronic pain is highly prevalent in older adults and can cause functional limitations, negatively affecting health and quality of life. Physical activity is a non-pharmacological approach used to prevent chronic pain as it promotes the release of endogenous opioids that block pain sensitivity. Therefore, we developed a systematic review protocol to analyse the relationship between physical activity and the occurrence and intensity of chronic pain in older adults. METHODS AND ANALYSES The systematic review will search PubMed, Scopus and Embase databases. The inclusion criteria will be observational studies that had primary chronic pain as an outcome, including persistent and intermittent pain. The population will include older adults from the community, living in a long-stay institution, or in outpatient follow-up. There will be no restriction regarding the year of publication and articles published in Portuguese, English and Spanish will be analysed. Effect or impact measures will be quantified, including OR, HR, prevalence ratio, incidence ratio and relative risk with their 95% CIs. If the data allow, a meta-analysis will be performed. The results may help understand the impact of physical activity as a potential protection factor against the occurrence of pain later in life as well as promote strategic prevention plans and public policies that encourage this practice in older adults. ETHICS AND DISSEMINATION Ethical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete. PROSPERO REGISTRATION NUMBER CRD42021282898.
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Affiliation(s)
| | | | | | - Matias Noll
- Campus Ceres, Federal Institute Goiano, Goiania, Goiás, Brazil
- Sports Medicine Clinic, Orthopaedic Department, Hospital of Lillebaelt, Odense, Denmark
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiania, GO, Brazil
- Department of Epidemiology & Public Health, University College London, London, UK
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16
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Büchel C. Pain persistence and the pain modulatory system: an evolutionary mismatch perspective. Pain 2022; 163:1274-1276. [PMID: 34855646 PMCID: PMC7612894 DOI: 10.1097/j.pain.0000000000002522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/13/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Christian Büchel
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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17
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Frequency of leisure activity engagement and health functioning over a 4-year period: a population-based study amongst middle-aged adults. BMC Public Health 2022; 22:1275. [PMID: 35773655 PMCID: PMC9248182 DOI: 10.1186/s12889-022-13670-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/21/2022] [Indexed: 11/28/2022] Open
Abstract
Rationale Leisure activities have wide-ranging benefits for physical and mental health. However, previous studies have often focused on “leisure” as a homogeneous group of activities. This study was therefore designed to take a prospective and comparative approach exploring different types of leisure activities, as well as investigating whether frequency of engagement is associated with strength of benefits. Method Data from the 1970 British Cohort Study Waves 9 (age 42) and 10 (age 46) were analysed (N = 5,639). Eight domains derived from the SF-36 health survey questionnaire were used to measure health functioning (general health, vitality, bodily pain, social functioning, physical functioning, mental health, role limitations due to emotional, and role limitations due to physical problems). Leisure activities included physical activity, culture engagement, arts participation, volunteering or community engagement, and literature activities. Both ordinary least squares and logistic regressions were applied. Results Physical activity was associated with greater levels of physical functioning, general health, and vitality at higher frequencies, while cultural engagement was associated with social functioning and physical functioning when engaged in several times a year. Arts participation and literature activities had a general negative association with health functioning. Engagements in volunteering/community groups showed varying associations with health functioning (both positive and negative) depending on the levels of engagements. Conclusion This research suggests that the types of leisure activities and levels of engagement can have differential associations with health amongst middle-aged adults. This may be helpful for public health initiatives and programmes such as social prescribing schemes when formulating programmes, especially regarding ‘dosage’ of engagement. Further, the overall benefits of high engagement frequency suggest that increasing leisure engagement could play an important role in supporting improving health and wellbeing at a population level. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13670-3.
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18
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Factors Associated with the Participation of Older Adults in Cultural and Sports Activities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106244. [PMID: 35627782 PMCID: PMC9141532 DOI: 10.3390/ijerph19106244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/15/2022] [Accepted: 05/18/2022] [Indexed: 11/24/2022]
Abstract
In the context of population aging, we have witnessed an increased interest in studying the participation of older persons in cultural and sport activities. The aim of this paper is to identify the participation rate in cultural and sports activities among Romanian older adults and the sociodemographics/behavioral variables that correlate with the participation rate in cultural and sports activities. In order to answer our research questions, we employed a questionnaire-based survey, and we used a nationally representative sample. Results point to low participation in both cultural and sports activities. Gender, residence, education, income, degree of mobility, internet connection, and availability of financial resources are significant variables that correlate with the engagement of older people in cultural and sports activities. Our study could serve as a base for concrete policy measures in the field of health and social inclusion of older persons.
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19
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The Transition from In-Person to Virtual Museum Programming for Individuals Living with Chronic Pain – A Formative Evaluation. J Clin Transl Sci 2022; 6:e58. [PMID: 35720968 PMCID: PMC9161051 DOI: 10.1017/cts.2022.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 11/07/2022] Open
Abstract
Museum engagement may be an effective approach for decreasing social disconnection and pain among individuals living with chronic pain. In October 2019, we launched a randomized controlled trial to assess the feasibility of museum engagement for individuals living with chronic pain; the study was halted in March, 2020 due to Covid-19-related safety concerns. This paper describes the process of transitioning from in-person to virtual museum programing in order to continue the study. Virtual museum programing is a feasible option for individuals living with chronic pain that is amenable to research and which may improve accessibility, inclusivity, and scalability relative to in-person programing.
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20
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Socioeconomic position and pain: a topical review. Pain 2022; 163:1855-1861. [PMID: 35297800 DOI: 10.1097/j.pain.0000000000002634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/02/2022] [Indexed: 11/26/2022]
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21
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Fluharty M, Paul E, Bone J, Bu F, Sonke J, Fancourt D. Difference in predictors and barriers to arts and cultural engagement with age in the United States: A cross-sectional analysis using the Health and Retirement Study. PLoS One 2021; 16:e0261532. [PMID: 34928997 PMCID: PMC8687585 DOI: 10.1371/journal.pone.0261532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 12/03/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Arts and cultural engagement are associated with a range of mental and physical health benefits, including promoting heathy aging and lower incidence of age-related disabilities such as slower cognitive decline and slower progression of frailty. This suggests arts engagement constitutes health-promoting behaviour in older age. However, there are no large-scale studies examining how the predictors of arts engagement vary with age. METHODS Data from the Health and Retirement Study (2014) were used to identify sociodemographic, life satisfaction, social, and arts appreciation predictors of (1) frequency of arts engagement, (2) cultural attendance, (3) difficulty participating in the arts, and (4) being an interested non-attendee of cultural events. Logistic regression models were stratified by age groups [50-59, 60-69, ≥70] for the frequency of arts participation outcome and [50-69 vs ≥70] all other outcomes. RESULTS Findings indicated a number of age-related predictors of frequent arts engagement, including gender, educational attainment, wealth, dissatisfaction with aging, and instrumental activities of daily living (iADL). For cultural event attendance, lower interest in the arts predicted lack of engagement across age groups, whereas higher educational attainment and more frequent religious service attendance became predictors in older age groups (≥ 70). Adults in both age groups were less likely to report difficulties engaging in the arts if they had lower neighbourhood safety, whilst poor self-rated health and low arts appreciation also predicted reduced likelihood of this outcome, but only in the younger (50-69) age group. Adults in the older (≥ 70) age group were more likely to be interested non-attendees of cultural events if they had higher educational attainment and less likely if they lived in neighbourhoods with low levels of safety. CONCLUSIONS Our results suggest that certain factors become stronger predictors of arts and cultural engagement and barriers to engagement as people age. Further, there appear to be socioeconomic inequalities in engagement that may increase in older ages, with arts activities overall more accessible as individuals age compared to cultural engagement due to additional financial barriers and transportation barriers. Ensuring that these activities are accessible to people of all ages will allow older adults to benefit from the range of health outcomes gained from arts and cultural engagement.
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Affiliation(s)
- Meg Fluharty
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health, University College London, London, United Kingdom
| | - Elise Paul
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health, University College London, London, United Kingdom
| | - Jessica Bone
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health, University College London, London, United Kingdom
| | - Feifei Bu
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health, University College London, London, United Kingdom
| | - Jill Sonke
- Center for Arts in Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Daisy Fancourt
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health, University College London, London, United Kingdom
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22
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Beauchet O, Cooper-Brown LA, Hayashi Y, Deveault M, Ho AHY, Launay CP. Health benefits of "Thursdays at the Montreal Museum of Fine Arts": Results of a randomized clinical trial. Maturitas 2021; 153:26-32. [PMID: 34654525 DOI: 10.1016/j.maturitas.2021.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 06/30/2021] [Accepted: 07/28/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE . This study aims to examine and compare changes in frailty status, well-being and quality of life in community-dwelling older adults living in Montreal (Quebec, Canada) participating in a 3-month session of weekly "Thursdays at the Museum" and in their control counterparts who did not participate in art-based activities. METHODS . 165 older community dwellers were recruited to a randomized controlled trial with two parallel groups (intervention versus control). The intervention was weekly participatory art-based activities over a 3-month period carried out at the Montreal Museum of Fine Arts (MMFA, Montreal, Quebec, Canada). Frailty, well-being and quality of life were assessed using standardized questionnaires completed at baseline (M0) and before the fifth (M1), ninth (M2) and twelfth (M3) workshops in the intervention group. The control group completed these questionnaires according to the same schedule. The outcomes were mean values of frailty, well-being and quality of life scores, as well as the distribution of frailty categories (vigorous versus mild, moderate and severe frailty) at M0, M1, M2 and M3. RESULTS . The intervention group showed significant improvements in frailty, well-being and quality of life scores (P≤0.004) when compared with the control group. CONCLUSION . The results suggest that the 3-month session of weekly "Thursdays at the Museum" may improve both physical and mental health in Montreal community-dwelling older adults.
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Affiliation(s)
- Olivier Beauchet
- Departments of Medicine, University of Montreal, Montreal, Quebec, Canada; Research Center of the Geriatric University institute of Montreal, Montreal, Quebec, Canada; Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
| | - Liam A Cooper-Brown
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
| | - Yoko Hayashi
- Faculty of Informatics for Arts Department of Information Expression, Shobi University, Kawagoe, Japan
| | - Melanie Deveault
- Education and Wellness Department of the Montreal Museum of Fine Arts, Montreal, Quebec, Canada
| | - Andy Hau Yan Ho
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore
| | - Cyrille P Launay
- Departments of Medicine, University of Montreal, Montreal, Quebec, Canada; Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
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23
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Ikeda T, Cooray U, Murakami M, Osaka K. Maintaining Moderate or Vigorous Exercise Reduces the Risk of Low Back Pain at 4 Years of Follow-Up: Evidence From the English Longitudinal Study of Ageing. THE JOURNAL OF PAIN 2021; 23:390-397. [PMID: 34583021 DOI: 10.1016/j.jpain.2021.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/04/2021] [Accepted: 08/27/2021] [Indexed: 11/25/2022]
Abstract
Few studies have examined whether maintaining moderate or vigorous physical activity (PA) reduces the risk of low back pain in older people. This study aimed to examine the magnitude of the associations of changes in PA on the risk of low back pain at 4 years of follow-up. We analyzed 4,882 participants in the English Longitudinal Study of Ageing who were initially free from low back pain (mean age, 65.6 ± 8.9 years at baseline). Self-reported PA, which was assessed at wave 6 (2012-2013) and wave 7 (2014-2015), was used as the exposure. The PA of the respondents was categorized into "no PA at all," "up to moderate PA," and "up to vigorous PA" groups. Self-reported moderate/severe low back pain assessed at 4 years of follow-up (2016-2017) was used as the outcome. Maintaining moderate (relative risk [RR], 0.59; 95% confidence interval [CI], 0.36-0.99) or vigorous (RR, 0.46; 95% CI, 0.27-0.77) PA at least 1-3 times a month was negatively associated with prevalence of low back pain compared with no PA at all. Interventions for maintaining either moderate or vigorous PA might be beneficial in preventing the incidence of low back pain in the older population. PERSPECTIVE: Perspective: This study examined the magnitude of the association between changes in physical activity over time and the risk of low back pain. The findings suggest that encouraging people to maintain at least moderate physical activity over 2 years is useful for reducing the risk of low back pain at 4 years of follow-up.
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Affiliation(s)
- Takaaki Ikeda
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan; Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan.
| | - Upul Cooray
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Masayasu Murakami
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
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24
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Li R, Dworkin RH, Chapman BP, Becerra AZ, Yang L, Mooney CJ, Seplaki CL. Moderate to Severe Chronic Pain in Later Life: Risk and Resilience Factors for Recovery. THE JOURNAL OF PAIN 2021; 22:1657-1671. [PMID: 34174387 DOI: 10.1016/j.jpain.2021.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/17/2021] [Accepted: 05/29/2021] [Indexed: 10/21/2022]
Abstract
Despite extensive research on the development and risk factors of chronic pain, the process of recovery from chronic pain in later life has been rarely studied. We estimated the recovery rate of moderate to severe chronic pain (chronic pain of moderate or severe severity or interfering with usual activities) among older adults and investigated predictors of recovery. Leveraging the longitudinal Health and Retirement Study 2006-2016 data (6 waves), we estimated the biennial national attrition-adjusted recovery rate of moderate to severe chronic pain among 6,132 US adults aged 65-75 at baseline. Generalized estimating equation Poisson models examined pain-related, sociodemographic, psychosocial and health-related factors in relation to recovery within any 2-year interval using longitudinal lagged design. Between 2006-2016, the prevalence of moderate to severe chronic pain increased from 28% to 33% with the incidence increasing from 14% to 18% and the recovery rate approximately 30%. Previous chronic pain duration, age, chronic diseases and a personality trait (agreeableness) were associated with a lower probability of recovery. Greater financial wealth and physical activity, better sleep quality and self-reported health were associated with a greater probability of recovery. Interventions that improve physical activity and sleep quality may be important avenues for reducing chronic pain burden among older adults. Perspective: Our longitudinal findings suggested that recovery from moderate to severe chronic pain is common in later life and we further identified several key factors associated with this recovery process. Future research should consider the potential of interventions that improve physical activity and sleep quality to enhance recovery among older adults.
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Affiliation(s)
- Rui Li
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York.
| | - Robert H Dworkin
- Department of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center, Rochester, New York; Department of Neurology, University of Rochester Medical Center, Rochester, New York; Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | - Benjamin P Chapman
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York; Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | - Adan Z Becerra
- Department of Surgery, Rush University Medical Center, Chicago, Illinois
| | - Luoying Yang
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York
| | - Christopher J Mooney
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York; Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Christopher L Seplaki
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York; Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
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25
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Fancourt D, Aughterson H, Finn S, Walker E, Steptoe A. How leisure activities affect health: a narrative review and multi-level theoretical framework of mechanisms of action. Lancet Psychiatry 2021; 8:329-339. [PMID: 33581775 PMCID: PMC7613155 DOI: 10.1016/s2215-0366(20)30384-9] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 01/24/2023]
Abstract
There is a large and growing body of evidence on the health benefits of engagement in leisure activities (voluntary, enjoyable non-work activities, such as hobbies, arts, volunteering, community group membership, sports, and socialising). However, there is no unifying framework explaining how leisure activities affect health: what the mechanisms of action are by which engagement with leisure activities leads to the prevention, management, or treatment of mental and physical illness. In this Review, we identify and map over 600 mechanisms of action. These mechanisms can be categorised as psychological, biological, social, and behavioural processes that operate at individual (micro), group (meso), and societal (macro) levels, and are synthesised into a new theoretical framework: the Multi-level Leisure Mechanisms Framework. This framework situates understanding of leisure activities within the theoretical lens of complex adaptive systems and aims to support the design of more theory-driven, cross-disciplinary studies.
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Affiliation(s)
- Daisy Fancourt
- Department of Behavioural Science & Health, University College London, London, UK.
| | - Henry Aughterson
- Department of Behavioural Science & Health, University College London, London, UK
| | - Saoirse Finn
- Department of Behavioural Science & Health, University College London, London, UK
| | - Emma Walker
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science & Health, University College London, London, UK
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O'Neill A, O'Sullivan K, McCreesh K. Lower levels of physical activity are associated with pain progression in older adults, a longitudinal study. Eur J Pain 2021; 25:1462-1471. [PMID: 33686731 DOI: 10.1002/ejp.1759] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/12/2021] [Accepted: 02/26/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND While pain is common in older adults, the association with physical activity remains unclear. Currently, the role physical activity plays in impacting pain developing over time is not well defined. METHODS Latent transition analysis (LTA) is a model-based approach to identifying underlying subgroups in a population, longitudinally, based on measured characteristics. In this study, LTA was used to explore the associations between physical activity levels and pain classes of adults aged over 50 years, from the Irish Longitudinal Study on Ageing (n = 8,175) across three waves of data collection (4 years). RESULTS Using three previously established pain classes (No Pain; Low-Moderate Impact Pain; High Impact Pain), 66% of older adults were classified as having 'No Pain' across the three waves. At Wave 1, individuals reporting low (OR = 4.00, 95% CI [3.21, 5.17]) or moderate (OR = 1.59, 95% CI [1.27, 1.99]) levels of physical activity are more likely to be in the High Impact Pain class, than the No Pain class. Longitudinally, individuals in the No Pain class with low or moderate physical activity were more likely to transition to the High Impact Pain class compared to those with higher physical activity scores (from Wave 1 to Wave 2, OR = 1.90, 95% CI [1.15, 3.37]; and from Wave 2 to Wave 3, OR = 2.27, 95% CI [1.40, 4.74]). CONCLUSION Older adults who do not meet minimum physical activity guidelines for moderate intensity exercise are at increased risk of higher impact pain when followed over 4 years. SIGNIFICANCE Older adults who do not meet minimum physical activity guidelines are at increased risk of transitioning to higher impact pain classes when followed over 4 years.
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Affiliation(s)
- Aoife O'Neill
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.,School of Allied Health, University of Limerick, Limerick, Ireland
| | - Kieran O'Sullivan
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.,School of Allied Health, University of Limerick, Limerick, Ireland
| | - Karen McCreesh
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.,School of Allied Health, University of Limerick, Limerick, Ireland
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Quigley TP, Amdam GV. Social modulation of ageing: mechanisms, ecology, evolution. Philos Trans R Soc Lond B Biol Sci 2021; 376:20190738. [PMID: 33678020 DOI: 10.1098/rstb.2019.0738] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Human life expectancy increases, but the disease-free part of lifespan (healthspan) and the quality of life in old people may not show the same development. The situation poses considerable challenges to healthcare systems and economies, and calls for new strategies to increase healthspan and for sustainable future approaches to elder care. This call has motivated innovative research on the role of social relationships during ageing. Correlative data from clinical surveys indicate that social contact promotes healthy ageing, and it is time to reveal the causal mechanisms through experimental research. The fruit fly Drosophila melanogaster is a prolific model animal, but insects with more developed social behaviour can be equally instrumental for this research. Here, we discuss the role of social contact in ageing, and identify lines of study where diverse insect models can help uncover the mechanisms that are involved. This article is part of the theme issue 'Ageing and sociality: why, when and how does sociality change ageing patterns?'
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Affiliation(s)
- Tyler P Quigley
- School of Life Sciences, Arizona State University, PO Box 874501, Tempe, AZ 85287, USA
| | - Gro V Amdam
- School of Life Sciences, Arizona State University, PO Box 874501, Tempe, AZ 85287, USA.,Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, PO Box 5002, N-1432 Aas, Norway
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28
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Loeffler A, Steptoe A. Bidirectional longitudinal associations between loneliness and pain, and the role of inflammation. Pain 2021; 162:930-937. [PMID: 32960533 PMCID: PMC7886943 DOI: 10.1097/j.pain.0000000000002082] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/23/2020] [Accepted: 09/14/2020] [Indexed: 12/25/2022]
Abstract
ABSTRACT Pain and loneliness are consistently associated, but the direction of the relationship is uncertain. We assessed bidirectional associations over a 4-year period in a sample of 4906 men and women (mean 65.1 ± 8.72 years) who were participants in the English Longitudinal Study of Ageing. The role of inflammation in these links was also investigated. Pain was defined by reports of being often troubled by pain at a moderate or severe intensity, whereas loneliness was measured using the shortened UCLA scale. Age, sex, ethnicity, educational attainment, wealth as a marker of socioeconomic resources, marital status, physical activity, and depressive symptoms were included as covariates. We found that baseline loneliness was associated with pain 4 years later after adjusting for baseline pain and other covariates (odds ratio [OR] = 1.25, 95% confidence interval [CI] 1.06-1.47, P = 0.007). Similarly, baseline pain independently predicted loneliness 4 years later (OR = 1.34, 95% CI 1.14-1.58, P = 0.001). Associations remained significant after additional adjustment for baseline mobility impairment. Likelihood of pain on follow-up was heightened when baseline loneliness was accompanied by elevated C-reactive protein concentration (OR = 1.50, 95% CI 1.13-2.00, P = 0.006), whereas inflammation did not predict future loneliness or contribute to the association between baseline pain and future loneliness. Both pain and loneliness are distressing experiences that impact well-being and quality of life. We conclude that there were bidirectional longitudinal relationships between pain and loneliness in this representative sample of older men and women, but that the mechanisms underlying these processes may differ.
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Affiliation(s)
- Anna Loeffler
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- Institute for Social Science Research, University of Queensland, Brisbane, Queensland, Australia
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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29
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Zaidel C, Musich S, Karl J, Kraemer S, Yeh CS. Psychosocial Factors Associated with Sleep Quality and Duration Among Older Adults with Chronic Pain. Popul Health Manag 2021; 24:101-109. [PMID: 32049579 PMCID: PMC7875123 DOI: 10.1089/pop.2019.0165] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Sleep complaints are common among older adults with chronic pain. Because of the risk of significant side effects, sleep medications are not recommended as first-line treatments. Little is known about the association between positive psychosocial factors and sleep, but further awareness could support non-drug strategies to minimize poor sleep. The purpose of this study was to (1) determine the prevalence of self-reported poor sleep quality and short/long sleep duration in a population of older adults with chronic pain, and (2) examine the associations of negative risk factors, sleep-inducing medications, and positive psychosocial characteristics on sleep outcomes in this population. This study analyzed survey responses from 4201 adults ages ≥65 years with diagnosed back pain, osteoarthritis, and/or rheumatoid arthritis, and at least 1 year of continuous medical and drug plan enrollment. The most commonly reported sleep outcome was short sleep duration (39%), followed by poor sleep quality (22%), and long sleep duration (9%). Based on pharmaceutical claims, prescriptions for opioids (59%) or benzodiazepines (22%) were common. Perceived stress, depression, and pain or sleep prescription medications were independently associated with poor sleep quality and short or long sleep durations. The positive psychosocial factors of higher resilience and more diverse social networks were independently associated with good sleep quality and optimal sleep duration. These results underscore the importance of social and coping factors to sleep, which may provide new opportunities to improve sleep and well-being in older adults with chronic pain.
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Affiliation(s)
| | - Shirley Musich
- Research for Aging Populations, Optum, Ann Arbor, Michigan, USA
| | - Jaycee Karl
- Research for Aging Populations, Optum, Ann Arbor, Michigan, USA
| | - Sandra Kraemer
- UnitedHealthcare Medicare and Retirement, Minneapolis, Minnesota, USA
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30
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Rogers NT, Fancourt D. Cultural Engagement Is a Risk-Reducing Factor for Frailty Incidence and Progression. J Gerontol B Psychol Sci Soc Sci 2020; 75:571-576. [PMID: 30624696 PMCID: PMC7768715 DOI: 10.1093/geronb/gbz004] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Indexed: 11/26/2022] Open
Abstract
Objectives Given that frailty is a multifaceted health condition of increasing importance to policy-makers and care providers, it is relevant to consider whether multimodal interventions could provide combined psychophysiological support. As studies have demonstrated the beneficial effects of cultural engagement (including visiting museums/theatre/cinema) for many of the components of frailty, this study sought to explore whether community cultural engagement is associated both with a reduced risk of becoming frail and a slower trajectory of frailty progression in older adults. Methods We used data from the English Longitudinal Study of Ageing to measure frequency of cultural engagement and both incident frailty and frailty progression over the following 10 years in 4,575 adults. Results Our analyses used competing risks regression models and multilevel growth curve models adjusting for socioeconomic, health behaviors, social confounders, and subthreshold symptoms of frailty. There was a dose–response relationship between increasing frequency of cultural engagement and both incidence and progression of frailty (attendance every few months or more: incidence subhazard ratio = 0.79, 95% confidence interval [CI] = 0.63 to 0.996; trajectory coefficient = –0.0039, 95% CI = –0.0059 to –0.0019). Discussion Older adults who engaged in cultural activities every few months or more had a reduced risk of becoming frail and a slower progression of frailty over time. Findings are in line with current calls for multimodal, multifactor, community approaches to support health in older age.
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Affiliation(s)
- Nina Trivedy Rogers
- Research Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, UK
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31
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Bernardo LD, Carvalho CRAD. The role of cultural engagement for older adults: an integrative review of scientific literature. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2020. [DOI: 10.1590/1981-22562020023.190141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: to understand the role of cultural engagement in the lives of older adults. Method: an integrative literature review of publications from 2014 and 2019 in English, Portuguese, and Spanish was conducted. The Scopus, Web of Science, MEDLINE/PubMed, CINAHL, PsycNET®, LILACS, SciELO Citation Index and Science Direct databases were used as sources of information. The descriptors “aged” and the related term “cultural engagement” in the three idioms were used in the search, together with the Boolean operators “AND” or “ OR”. A total of 12 articles that met the inclusion criteria were found. These were categorized based on the theme. No Brazilian studies were found. Results: the panorama found revealed that older adults are more interested in receptive cultural activities, such as going to museums, exhibitions and the theater, as these enrich and add greater social value to their lives. Cultural engagement was associated with a reduction in the incidence of neuropsychiatric disorders (dementia and depression), as well as reducing the incidence of episodes of violence. Participation in cultural activities also constituted a protective factor for cognitive abilities and for the reduction of chronic pain. There is also evidence that associates cultural engagement with a better perception of quality of life and greater well-being, happiness and positive affect, as well as the reduction of negative affect. Conclusion: engaging in cultural activities is a way of understanding and respecting cultural diversity, salvaging social identities, and enjoying and providing experiences of great social value, with beneficial impacts in the lives of older adults.
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32
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Fancourt D, Steptoe A. The art of life and death: 14 year follow-up analyses of associations between arts engagement and mortality in the English Longitudinal Study of Ageing. BMJ 2019; 367:l6377. [PMID: 31852659 PMCID: PMC7190042 DOI: 10.1136/bmj.l6377] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/24/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To explore associations between different frequencies of arts engagement and mortality over a 14 year follow-up period. DESIGN Prospective cohort study. PARTICIPANTS English Longitudinal Study of Ageing cohort of 6710 community dwelling adults aged 50 years and older (53.6% women, average age 65.9 years, standard deviation 9.4) who provided baseline data in 2004-05. INTERVENTION Self reported receptive arts engagement (going to museums, art galleries, exhibitions, the theatre, concerts, or the opera). MEASUREMENT Mortality measured through data linkage to the National Health Service central register. RESULTS People who engaged with receptive arts activities on an infrequent basis (once or twice a year) had a 14% lower risk of dying at any point during the follow-up (809/3042 deaths, hazard ratio 0.86, 95% confidence interval 0.77 to 0.96) compared with those who never engaged (837/1762 deaths). People who engaged with receptive arts activities on a frequent basis (every few months or more) had a 31% lower risk of dying (355/1906 deaths, 0.69, 0.59 to 0.80), independent of demographic, socioeconomic, health related, behavioural, and social factors. Results were robust to a range of sensitivity analyses with no evidence of moderation by sex, socioeconomic status, or social factors. This study was observational and so causality cannot be assumed. CONCLUSIONS Receptive arts engagement could have a protective association with longevity in older adults. This association might be partly explained by differences in cognition, mental health, and physical activity among those who do and do not engage in the arts, but remains even when the model is adjusted for these factors.
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Affiliation(s)
- Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London WC1E 7HB, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London WC1E 7HB, UK
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33
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Mulligan K, Bhatti S, Rayner J, Hsiung S. Reply to: Looking Before We Leap: Building the Evidence for Social Prescribing for Lonely Older Adults. J Am Geriatr Soc 2019; 68:434-435. [PMID: 31840799 DOI: 10.1111/jgs.16254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 10/14/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Kate Mulligan
- School of Social & Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Alliance for Healthier Communities, Toronto, Canada
| | - Sara Bhatti
- Alliance for Healthier Communities, Toronto, Canada
| | - Jennifer Rayner
- Alliance for Healthier Communities, Toronto, Canada.,Centre for Studies in Family Medicine, University of Western Ontario, London, Canada
| | - Sonia Hsiung
- Alliance for Healthier Communities, Toronto, Canada
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34
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Mulligan K, Bhatti S, Rayner J, Hsiung S. Social Prescribing: Creating Pathways Towards Better Health and Wellness. J Am Geriatr Soc 2019; 68:426-428. [DOI: 10.1111/jgs.16249] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/05/2019] [Accepted: 09/08/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Kate Mulligan
- School of Social and Behavioural Health Sciences, Dalla Lana School of Public HealthUniversity of Toronto Toronto Ontario Canada
- Alliance for Healthier Communities Toronto Ontario Canada
| | - Sara Bhatti
- Alliance for Healthier Communities Toronto Ontario Canada
| | - Jennifer Rayner
- Alliance for Healthier Communities Toronto Ontario Canada
- Centre for Studies in Family MedicineUniversity of Western Ontario London Ontario Canada
| | - Sonia Hsiung
- Alliance for Healthier Communities Toronto Ontario Canada
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35
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Beems MEC, Toonders SAJ, van Westrienen PE, Veenhof C, Pisters MF. Identifying subgroups based on self-management skills in primary care patients with moderate medically unexplained physical symptoms. J Psychosom Res 2019; 125:109785. [PMID: 31421323 DOI: 10.1016/j.jpsychores.2019.109785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 07/15/2019] [Accepted: 07/20/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Medically Unexplained Physical Symptoms (MUPS) are a major burden on both patients and society and frequently develop into chronic MUPS. Self-management interventions may prevent moderate MUPS from becoming chronic. Tailoring interventions to the patient population is strongly recommended. This can be facilitated by identifying subgroups based on self-management skills. This study aimed to identify these subgroups and their clinical profiles in primary care patients with moderate MUPS. METHODS A cross-sectional study was performed on baseline measurements from a randomized clinical trial (PARASOL-study). To identify subgroups based on self-management skills, a hierarchical cluster analysis was conducted for adults with moderate MUPS from primary health care centers. Self-management skills were measured with the Health education impact Questionnaire. Cluster variables were seven constructs of this questionnaire. Additionally, specific patient profiles were determined by comparing the identified clusters on the clinical variables pain, fatigue and physical functioning. RESULTS Four subgroups were identified: High-Self-Management Skills (SMS) (n = 29), Medium-SMS (n = 55), Low-SMS (n = 49) and Active & Low Distress-SMS (n = 20). The latter showed a distinctly different pattern on cluster variables, while the other subgroups differed significantly on means of the cluster variables (p < .001). On clinical variables, significant differences between subgroups were mainly found on fatigue and physical functioning. CONCLUSION This study found four specific subgroups based on self-management skills in moderate MUPS-patients. One subgroup demonstrated a distinctly different pattern on self-management skills. In other subgroups, more similar patterns on self-management skills were found that negatively correlated with pain and fatigue and positively correlated with physical functioning.
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Affiliation(s)
- M E C Beems
- Physical Therapy Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, the Netherlands; Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care Centers, Utrecht, the Netherlands; Fysio Center Den Haag, The Hague, the Netherlands.
| | - S A J Toonders
- Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care Centers, Utrecht, the Netherlands; Physical Therapy Research, Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Health Innovation and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands.
| | - P E van Westrienen
- Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care Centers, Utrecht, the Netherlands; Physical Therapy Research, Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Health Innovation and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands.
| | - C Veenhof
- Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care Centers, Utrecht, the Netherlands; Physical Therapy Research, Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands; Expertise Center Innovation of Care, Research Group Innovation of Mobility Care, Utrecht University of Applied Sciences, Utrecht, the Netherlands.
| | - M F Pisters
- Physical Therapy Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, the Netherlands; Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care Centers, Utrecht, the Netherlands; Physical Therapy Research, Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Health Innovation and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands.
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36
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Williams ACDC. Persistence of pain in humans and other mammals. Philos Trans R Soc Lond B Biol Sci 2019; 374:20190276. [PMID: 31544608 DOI: 10.1098/rstb.2019.0276] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Evolutionary models of chronic pain are relatively undeveloped, but mainly concern dysregulation of an efficient acute defence, or false alarm. Here, a third possibility, mismatch with the modern environment, is examined. In ancestral human and free-living animal environments, survival needs urge a return to activity during recovery, despite pain, but modern environments allow humans and domesticated animals prolonged inactivity after injury. This review uses the research literature to compare humans and other mammals, who share pain neurophysiology, on risk factors for pain persistence, behaviours associated with pain, and responses of conspecifics to behaviours. The mammal populations studied are mainly laboratory rodents in pain research, and farm and companion animals in veterinary research, with observations of captive and free-living primates. Beyond farm animals and rodent models, there is virtually no evidence of chronic pain in other mammals. Since evidence is sparse, it is hard to conclude that it does not occur, but its apparent absence is compatible with the mismatch hypothesis. This article is part of the Theo Murphy meeting issue 'Evolution of mechanisms and behaviour important for pain'.
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Affiliation(s)
- Amanda C de C Williams
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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37
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Williams ACDC. Pain management programmes in the United Kingdom: lessons for us all. Br J Pain 2019; 13:71-73. [PMID: 31019687 DOI: 10.1177/2049463719840064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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