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      Factors Associated with Life Satisfaction in Older Adults with Chronic Pain (PainS65+)

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          Abstract

          Background

          Chronic pain in later life is a worldwide problem. In younger patients, chronic pain affects life satisfaction negatively; however, it is unknown whether this outcome will extend into old age.

          Objective

          This study examines which factors determine life satisfaction in older adults who suffer from chronic pain with respect to socio-demographics, lifestyle behaviors, pain, and comorbidities.

          Methods

          This cross-sectional study recruited a random sample of people ≥65 years old living in south-eastern Sweden (N= 6611). A postal survey addressed pain aspects and health experiences. Three domains from the Life Satisfaction Questionnaire (LiSat-11) were used to capture the individual’s estimations of overall satisfaction (LiSat-life), somatic health (LiSat-somhealth), and psychological health (LiSat-psychhealth).

          Results

          Respondents with chronic pain (2790, 76.2±7.4 years old) rated lower on life satisfaction than those without chronic pain, with medium effect size (ES) on LiSat-somhealth (r = 0.38, P < 0.001) and small ES on the other two domains (r < 0.3). Among the respondents with chronic pain, severe pain (OR 0.29–0.59) and pain spreading (OR 0.87–0.95) were inversely associated with all three domains of the LiSat-11. Current smoking, alcohol overconsumption, and obesity negatively affected one or more domains of the LiSat-11. Most comorbidities were negatively related to LiSat-somhealth, and some comorbidities affected the other two domains. For example, having tumour or cancer negatively affected both LiSat-life (OR 0.62, 95% CI 0.44–0.88) and LiSat-somhealth (OR 0.42, 95% CI 0.24–0.74). Anxiety or depression disorders had a negative relationship both for LiSat-life (OR 0.54, 95% CI 0.38–0.78) and LiSat-psychhealth (OR 0.10, 95% CI 0.06–0.14).

          Conclusion

          Older adults with chronic pain reported lower life satisfaction but the difference from their peers without chronic pain was trivial, except for satisfaction with somatic health. Pain management in old age needs to consider comorbidities and severe pain to improve patients’ life satisfaction.

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          Most cited references 65

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          Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey.

          To assess the association between sleep problems and chronic disease in older adults. Self-reported standardized questionnaire data from 1506 community-dwelling men and women aged 55-84 years in the continental United States who completed a 20-min telephone interview when contacted from lists of randomly selected telephone numbers. A majority of the participants (83%) reported one or more of 11 medical conditions and nearly one in four elderly respondents (age 65-84 years) had major comorbidity (i.e. four or more conditions). Depression, heart disease, bodily pain and memory problems were associated with more prevalent symptoms of insomnia. Other conditions such as obesity, arthritis, diabetes, lung diseases, stroke and osteoporosis were associated with other sleep-related problems such as breathing pauses, snoring, daytime sleepiness, restless legs or insufficient sleep (<6 h nightly). Poll findings are consistent with epidemiological studies of sleep, aging and chronic disease. These results suggest that the sleep complaints common in older adults are often secondary to their comorbidities and not to aging per se. These types of studies may be useful in promoting sleep awareness among health professionals and among older adults, especially those with heart disease, depression, chronic bodily pain or major comorbidity.
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            Negative life events, social support and gender difference in depression: a multinational community survey with data from the ODIN study.

            To explore if differences in negative life events, vulnerability and social support may explain the gender difference in depression. Cross-sectional, multinational, community survey from five European countries (n = 8,787). Depression is measured by Beck Depression Inventory, whereas negative life events and social support are measured by various questionnaires. Women report slightly more negative life events than men do, mainly related to the social network, but more social support in general and in connection with reported life events. This trend is the same in all participating countries except Spain, where there is no gender difference in the reported support. In general, women are not more vulnerable to negative life events than men are. However, women with no social support, who are exposed to life events, are more vulnerable than men without support. The higher rate of depression in women is not explained by gender differences in negative life events, social support or vulnerability.
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              A snapshot of the age distribution of psychological well-being in the United States.

              Psychological well-being (WB) includes a person's overall appraisal of his or her life (Global WB) and affective state (Hedonic WB), and it is considered a key aspect of the health of individuals and groups. Several cross-sectional studies have documented a relation between Global WB and age. Little is known, however, about the age distribution of Hedonic WB. It may yield a different view of aging because it is less influenced by the cognitive reconstruction inherent in Global WB measures and because it includes both positive and negative components of WB. In this study we report on both Global and Hedonic WB assessed in a 2008 telephone survey of 340,847 people in the United States. Consistent with prior studies, Global WB and positive Hedonic WB generally had U-shaped age profiles showing increased WB after the age of 50 years. However, negative Hedonic WB variables showed distinctly different and stronger patterns: Stress and Anger steeply declined from the early 20s, Worry was elevated through middle age and then declined, and Sadness was essentially flat. Unlike a prior study, men and women had very similar age profiles of WB. Several measures that could plausibly covary with the age-WB association (e.g., having children at home) did not alter the age-WB patterns. Global and Hedonic WB measures appear to index different aspects of WB over the lifespan, and the postmidlife increase in WB, especially in Hedonic WB, deserves continued exploration.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                JPR
                jpainres
                Journal of Pain Research
                Dove
                1178-7090
                05 March 2020
                2020
                : 13
                : 475-489
                Affiliations
                [1 ]Pain and Rehabilitation Centre, Department of Health, Medicine, and Caring Sciences, Linköping University , Linköping, Sweden
                [2 ]Unit of Health Care Analysis, Division of Society and Health, Department of Health, Medicine and Caring Sciences, Linköping University , Linköping, SE-581 85, Sweden
                Author notes
                Correspondence: Huan-Ji Dong Pain and Rehabilitation Centre, University Hospital , LinköpingSE 581 85, SwedenTel +46 73 048 8933Fax +46 10 103 4906 Email huanji.dong@liu.se
                Article
                234565
                10.2147/JPR.S234565
                7062502
                32184652
                © 2020 Dong et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 2, Tables: 2, References: 83, Pages: 15
                Categories
                Original Research

                Anesthesiology & Pain management

                comorbidity, older adults, life satisfaction, chronic pain

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