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Presto P, Sehar U, Kopel J, Reddy PH. Mechanisms of pain in aging and age-related conditions: Focus on caregivers. Ageing Res Rev 2024; 95:102249. [PMID: 38417712 DOI: 10.1016/j.arr.2024.102249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 03/01/2024]
Abstract
Pain is a complex, subjective experience that can significantly impact quality of life, particularly in aging individuals, by adversely affecting physical and emotional well-being. Whereas acute pain usually serves a protective function, chronic pain is a persistent pathological condition that contributes to functional deficits, cognitive decline, and emotional disturbances in the elderly. Despite substantial progress that has been made in characterizing age-related changes in pain, complete mechanistic details of pain processing mechanisms in the aging patient remain unknown. Pain is particularly under-recognized and under-managed in the elderly, especially among patients with Alzheimer's disease (AD), Alzheimer's disease-related dementias (ADRD), and other age-related conditions. Furthermore, difficulties in assessing pain in patients with AD/ADRD and other age-related conditions may contribute to the familial caregiver burden. The purpose of this article is to discuss the mechanisms and risk factors for chronic pain development and persistence, with a particular focus on age-related changes. Our article also highlights the importance of caregivers working with aging chronic pain patients, and emphasizes the urgent need for increased legislative awareness and improved pain management in these populations to substantially alleviate caregiver burden.
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Affiliation(s)
- Peyton Presto
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Jonathan Kopel
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Nutritional Sciences Department, College of Human Sciences, Texas Tech University, Lubbock, TX 79409, USA; Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Public Health, School of Population and Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Neurology, Departments of School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
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Strath LJ, Peterson JA, Meng L, Rani A, Huo Z, Foster TC, Fillingim RB, Cruz-Almeida Y. Socioeconomic Status, Knee Pain, and Epigenetic Aging in Community-Dwelling Middle-to-Older Age Adults. THE JOURNAL OF PAIN 2024; 25:293-301. [PMID: 37315728 PMCID: PMC10713866 DOI: 10.1016/j.jpain.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 05/22/2023] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
Chronic musculoskeletal pain is often associated with lower socioeconomic status (SES). SES correlates with psychological and environmental conditions that could contribute to the disproportionate burden of chronic stress. Chronic stress can induce changes in global DNA methylation and gene expression, which increases risk of chronic pain. We aimed to explore the association of epigenetic aging and SES in middle-to-older age individuals with varying degrees of knee pain. Participants completed self-reported pain, a blood draw, and answered demographic questions pertaining to SES. We used an epigenetic clock previously associated with knee pain (DNAmGrimAge) and the subsequent difference of predicted epigenetic age (DNAmGrimAge-Diff). Overall, the mean DNAmGrimAge was 60.3 (±7.6), and the average DNAmGrimAge-diff was 2.4 years (±5.6 years). Those experiencing high-impact pain earned less income and had lower education levels compared to both low-impact and no pain groups. Differences in DNAmGrimAge-diff across pain groups were found, whereby individuals with high-impact pain had accelerated epigenetic aging (∼5 years) compared to low-impact pain and no pain control groups (both ∼1 year). Our main finding was that epigenetic aging mediated the associations of income and education with pain impact, as such the relationship between SES and pain outcomes may occur through potential interactions with the epigenome reflective of accelerated cellular aging. PERSPECTIVE: Socioeconomic status (SES) has previously been implicated in the pain experience. The present manuscript aims to present a potential social-biological link between SES and pain via accelerated epigenetic aging.
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Affiliation(s)
- Larissa J. Strath
- Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL
| | - Jessica A. Peterson
- Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL
| | - Lingsong Meng
- Department of Biostatistics, University of Florida, Gainesville, FL
| | - Asha Rani
- Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville FL
| | - Zhiguang Huo
- Department of Biostatistics, University of Florida, Gainesville, FL
| | - Thomas C. Foster
- Genetics and Genomics Program, University of Florida, Gainesville Florida
| | - Roger B. Fillingim
- Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL
| | - Yenisel Cruz-Almeida
- Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL
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Cruz-Almeida Y, Tamargo J, Strath LJ. Epigenetic Aging: A Socio-Biological Link to Chronic Pain? THE JOURNAL OF PAIN 2024; 25:572-573. [PMID: 37984508 DOI: 10.1016/j.jpain.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/22/2023]
Affiliation(s)
- Yenisel Cruz-Almeida
- Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, Florida; Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida; Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, Florida
| | - Javier Tamargo
- Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, Florida; Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida
| | - Larissa J Strath
- Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, Florida; Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida
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Weerasekera A, Knight PC, Alshelh Z, Morrissey EJ, Kim M, Zhang Y, Napadow V, Anzolin A, Torrado-Carvajal A, Edwards RR, Ratai EM, Loggia ML. Thalamic neurometabolite alterations in chronic low back pain: a common phenomenon across musculoskeletal pain conditions? Pain 2024; 165:126-134. [PMID: 37578456 PMCID: PMC10841327 DOI: 10.1097/j.pain.0000000000003002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/14/2023] [Indexed: 08/15/2023]
Abstract
ABSTRACT Recently, we showed that patients with knee osteoarthritis (KOA) demonstrate alterations in the thalamic concentrations of several metabolites compared with healthy controls: higher myo-inositol (mIns), lower N-acetylaspartate (NAA), and lower choline (Cho). Here, we evaluated whether these metabolite alterations are specific to KOA or could also be observed in patients with a different musculoskeletal condition, such as chronic low back pain (cLBP). Thirty-six patients with cLBP and 20 healthy controls were scanned using 1 H-magnetic resonance spectroscopy (MRS) and a PRESS (Point RESolved Spectroscopy) sequence with voxel placement in the left thalamus. Compared with healthy controls, patients with cLBP demonstrated lower absolute concentrations of NAA ( P = 0.0005) and Cho ( P < 0.05) and higher absolute concentrations of mIns ( P = 0.01) when controlling for age, as predicted by our previous work in KOA. In contrast to our KOA study, mIns levels in this population did not significantly correlate with pain measures (eg, pain severity or duration). However, exploratory analyses revealed that NAA levels in patients were negatively correlated with the severity of sleep disturbance ( P < 0.01), which was higher in patients compared with healthy controls ( P < 0.001). Additionally, also in patients, both Cho and mIns levels were positively correlated with age ( P < 0.01 and P < 0.05, respectively). Altogether, these results suggest that thalamic metabolite changes may be common across etiologically different musculoskeletal chronic pain conditions, including cLBP and KOA, and may relate to symptoms often comorbid with chronic pain, such as sleep disturbance. The functional and clinical significance of these brain changes remains to be fully understood.
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Affiliation(s)
- Akila Weerasekera
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Paulina C. Knight
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Zeynab Alshelh
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Erin J. Morrissey
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Minhae Kim
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Yi Zhang
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Vitaly Napadow
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Alessandra Anzolin
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Angel Torrado-Carvajal
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
- Medical Image Analysis and Biometry Laboratory, Universidad Rey Juan Carlos, Madrid, Spain
| | - Robert R. Edwards
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Eva-Maria Ratai
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Marco L. Loggia
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Jackson P, Spector AL, Strath LJ, Antoine LH, Li P, Goodin BR, Hidalgo BA, Kempf MC, Gonzalez CE, Jones AC, Foster TC, Peterson JA, Quinn T, Huo Z, Fillingim R, Cruz-Almeida Y, Aroke EN. Epigenetic age acceleration mediates the relationship between neighborhood deprivation and pain severity in adults with or at risk for knee osteoarthritis pain. Soc Sci Med 2023; 331:116088. [PMID: 37473540 PMCID: PMC10407756 DOI: 10.1016/j.socscimed.2023.116088] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/08/2023] [Accepted: 07/08/2023] [Indexed: 07/22/2023]
Abstract
An estimated 250 million people worldwide suffer from knee osteoarthritis (KOA), with older adults having greater risk. Like other age-related diseases, residents of high-deprivation neighborhoods experience worse KOA pain outcomes compared to their more affluent neighbors. The purpose of this study was to examine the relationship between neighborhood deprivation and pain severity in KOA and the influence of epigenetic age acceleration (EpAA) on that relationship. The sample of 128 participants was mostly female (60.9%), approximately half non-Hispanic Black (49.2%), and had a mean age of 58 years. Spearman bivariate correlations revealed that pain severity positively correlated with EpAA (ρ = 0.47, p ≤ 0.001) and neighborhood deprivation (ρ = 0.25, p = 0.004). We found a positive significant relationship between neighborhood deprivation and EpAA (ρ = 0.47, p ≤ 0.001). Results indicate a mediating relationship between neighborhood deprivation (predictor), EpAA (mediator), and pain severity (outcome variable). There was a significant indirect effect of neighborhood deprivation on pain severity through EpAA, as the mediator accounted for a moderate portion of the total effect, PM = 0.44. Epigenetic age acceleration may act as a mechanism through which neighborhood deprivation leads to worse KOA pain outcomes and may play a role in the well-documented relationship between the neighborhood of residence and age-related diseases.
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Affiliation(s)
- Pamela Jackson
- School of Public Health, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
| | - Antoinette L Spector
- School of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI, 53201, USA; Pain Research and Intervention Center of Excellence (PRICE), University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.
| | - Larissa J Strath
- Department of Community Dentistry and Behavioral Science, University of Florida, 1329 16th Street Southwest, Gainesville, FL, 32608, USA; Pain Research and Intervention Center of Excellence (PRICE), University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.
| | - Lisa H Antoine
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
| | - Peng Li
- School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
| | - Burel R Goodin
- Washington University Pain Center, Department of Anesthesiology, Washington University School of Medicine in St. Louis, USA.
| | - Bertha A Hidalgo
- School of Public Health, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
| | - Mirjam-Colette Kempf
- School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
| | - Cesar E Gonzalez
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
| | - Alana C Jones
- School of Public Health, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
| | - Thomas C Foster
- Department of Neuroscience, University of Florida, 1149 Newell Dr, Gainesville, FL, 32610, USA.
| | - Jessica A Peterson
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.
| | - Tammie Quinn
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
| | - Zhiguang Huo
- Department of Biostatistics, University of Florida, 2004 Mowry Road, Gainesville, FL, 32603, USA.
| | - Roger Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, 1329 16th Street Southwest, Gainesville, FL, 32608, USA; Pain Research and Intervention Center of Excellence (PRICE), University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.
| | - Yenisel Cruz-Almeida
- Department of Community Dentistry and Behavioral Science, University of Florida, 1329 16th Street Southwest, Gainesville, FL, 32608, USA; Pain Research and Intervention Center of Excellence (PRICE), University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA; Department of Neuroscience, University of Florida, 1149 Newell Dr, Gainesville, FL, 32610, USA.
| | - Edwin N Aroke
- School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
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Peterson JA, Crow JA, Johnson AJ, Meng L, Rani A, Huo Z, Foster TC, Fillingim RB, Cruz-Almeida Y. Pain interference mediates the association between epigenetic aging and grip strength in middle to older aged males and females with chronic pain. Front Aging Neurosci 2023; 15:1122364. [PMID: 37032822 PMCID: PMC10077493 DOI: 10.3389/fnagi.2023.1122364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/20/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Chronic pain is one of the leading causes of disability that may accelerate biological aging and reduce physical function. Epigenetic clocks provide an estimate of how the system ages and can predict health outcomes such as physical function. Physical function declines may be attributed to decreases in muscle quality due to disuse that can be measured quickly and noninvasively using grip strength. The purpose of this study was to explore the associations among self-reported pain, grip strength, and epigenetic aging in those with chronic pain. Methods Participants (57.91 ± 8.04 years) completed pain questionnaires, a blood draw and hand grip strength task. We used an epigenetic clock previously associated with knee pain (DNAmGrimAge), and used the subsequent difference of predicted epigenetic age from chronological age (DNAmGrimAge-Difference). Results Exploratory pathway analyses revealed that pain intensity mediated the association between DNAmGrimAge-difference and handgrip strength in males only (β = -0.1115; CI [-0.2929, -0.0008]) and pain interference mediated the association between DNAmGrimAge-difference and handgrip strength in males β = -0.1401; CI [-0.3400, -0.0222]), and females (β = -0.024; CI [-0.2918, -0.0020]). Discussion Chronic knee pain may accelerate epigenetic aging processes that may influence handgrip strength in older age adults. Chronic pain could be a symptom of the aging body thus contributing to declines in musculoskeletal function in later life.
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Affiliation(s)
- Jessica A. Peterson
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Joshua A. Crow
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Alisa J. Johnson
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Lingsong Meng
- Department of Biostatistics, University of Florida, Gainesville, FL, United States
| | - Asha Rani
- Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Zhiguang Huo
- Department of Biostatistics, University of Florida, Gainesville, FL, United States
| | - Thomas C. Foster
- Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Genetics and Genomics Program, University of Florida, Gainesville, FL, United States
| | - Roger B. Fillingim
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
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Peterson JA, Staud R, Thomas PA, Goodin BR, Fillingim RB, Cruz-Almeida Y. Self-reported pain and fatigue are associated with physical and cognitive function in middle to older-aged adults. Geriatr Nurs 2023; 50:7-14. [PMID: 36640518 PMCID: PMC10316316 DOI: 10.1016/j.gerinurse.2022.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 01/15/2023]
Abstract
Persistent fatigue is often reported in those with chronic musculoskeletal pain. Separately, both chronic pain and chronic fatigue contribute to physical and cognitive decline in older adults. Concurrent pain and fatigue symptoms may increase disability and diminish quality of life, though little data exist to show this. The purpose of this study was to examine associations between self-reported pain and fatigue, both independently and combined, with cognitive and physical function in middle-older-aged adults with chronic knee pain. Using a cross-sectional study design participants (n = 206, age 58.0 ± 8.3) completed questionnaires on pain and fatigue, a physical performance battery to assess physical function, and the Montreal Cognitive Assessment. Hierarchical regressions and moderation analyses were used to assess the relationship between the variables of interest. Pain and fatigue both predicted physical function (β = -0.305, p < 0.001; β = -0.219, p = 0.003, respectively), however only pain significantly predicted cognitive function (β = -0.295, p <0.001). A centered pain*fatigue interaction was a significant predictor of both cognitive function (β = -0.137, p = 0.049) and physical function (β = -0.146, p = 0.048). These findings indicate that self-reported fatigue may contribute primarily to decline in physical function among individuals with chronic pain, and less so to decline in cognitive function. Future studies should examine the impact of both cognitive and physical function decline together on overall disability and health.
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Affiliation(s)
- Jessica A Peterson
- College of Dentistry, Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA; College of Dentistry, Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Roland Staud
- College of Dentistry, Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA; College of Medicine, Rheumatology, University of Florida, Gainesville, FL, USA
| | - Pavithra A Thomas
- College of Arts and Science, Psychology, University of Alabama at Birmingham, Birmingham, AL, USA; School of Medicine, Center for Addiction & Pain Prevention & Intervention (CAPPI), University of Alabama at Birmingham, Birmingham, AL, USA
| | - Burel R Goodin
- College of Arts and Science, Psychology, University of Alabama at Birmingham, Birmingham, AL, USA; School of Medicine, Center for Addiction & Pain Prevention & Intervention (CAPPI), University of Alabama at Birmingham, Birmingham, AL, USA
| | - Roger B Fillingim
- College of Dentistry, Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA; College of Dentistry, Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- College of Dentistry, Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA; College of Dentistry, Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA; Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
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Peterson JA, Johnson A, Nordarse CL, Huo Z, Cole J, Fillingim RB, Cruz-Almeida Y. Brain predicted age difference mediates pain impact on physical performance in community dwelling middle to older aged adults. Geriatr Nurs 2023; 50:181-187. [PMID: 36787663 PMCID: PMC10360023 DOI: 10.1016/j.gerinurse.2023.01.019] [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: 12/21/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 02/16/2023]
Abstract
The purpose of the study was to examine associations between physical performance and brain aging in individuals with knee pain and whether the association between pain and physical performance is mediated by brain aging. Participants (n=202) with low impact knee pain (n=111), high impact knee pain (n=60) and pain-free controls (n=31) completed self-reported pain, magnetic resonance imaging (MRI), and a Short Physical Performance Battery (SPPB) that included balance, walking, and sit to stand tasks. Brain predicted age difference, calculated using machine learning from MRI images, significantly mediated the relationships between walking and knee pain impact (CI: -0.124; -0.013), walking and pain-severity (CI: -0.008; -0.001), total SPPB score and knee pain impact (CI: -0.232; -0.025), and total SPPB scores and pain-severity (CI: -0.019; -0.001). Brain-aging begins to explain the association between pain and physical performance, especially walking. This study supports the idea that a brain aging prediction can be calculated from shorter duration MRI sequences and possibly implemented in a clinical setting to be used to identify individuals with pain who are at risk for accelerated brain atrophy and increased likelihood of disability.
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Affiliation(s)
- Jessica A Peterson
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA; Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL 32610, USA
| | - Alisa Johnson
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA; Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL 32610, USA
| | - Chavier Laffitte Nordarse
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA; Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL 32610, USA
| | - Zhiguang Huo
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - James Cole
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK; Psychology and Neuroscience, King's College London, Institute of Psychiatry, London, UK; Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Roger B Fillingim
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA; Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL 32610, USA
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA; Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL 32610, USA.
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