Widespread Musculoskeletal Pain and the Progression of Disability in Older Disabled Women

Widespread Musculoskeletal Pain and the Progression of Disability in Older Disabled Women

From Hebrew Rehabilitation Center for Aged, Boston, Massachusetts; The Johns Hopkins University Schools of Medicine and Public Health, University of Maryland, and Maryland Veterans Affairs Health Care System, Baltimore, Maryland; and National Institute on Aging, Bethesda, Maryland.

Abstract

Background: Widespread musculoskeletal pain is a poorly understood but common problem in older adults. Little is known about the progression of disability related to this condition.

Objective: To determine whether widespread musculoskeletal pain increases the risk for worsening disability in older women with disabilities.

Design: Prospective cohort study.

Setting: The Women's Health and Aging Study.

Participants: 1002 community-dwelling women 65 years of age or older with disability.

Measurements: Widespread musculoskeletal pain was defined as pain in the upper and lower extremities and axial pain with moderate or severe pain in at least one of the three regions. Worsening disability was defined as progression from no or mild difficulty to severe difficulty or inability to perform activities of daily living (ADLs), walk one-quarter mile, or lift 10 lbs.

Results: At baseline, 24% of participants had widespread pain and 25% had no pain or only mild pain in a single site. Women with widespread pain were 2.5 to 3.5 times more likely to have severe difficulty with ADLs, walking, or lifting at baseline compared with women who had no or mild pain. In women without severe difficulty initially, widespread pain nearly doubled the risk for progression to severe difficulty in each of the tasks, after adjustment for age, body mass index, comorbid illness, and other confounders.

Conclusion: Widespread musculoskeletal pain is frequent among community-dwelling older women with disability and appears to predict the progression of disability. Efforts to better understand the cause of this pain and its treatment might reduce the overall burden of disability.

Article and Author Information

Grant Support: By the Brookdale National Fellowship Program (Dr. Bandeen-Roche). This work was conducted in part while Dr. Leveille was a Research Fellow with the Epidemiology, Demography, and Biometry Program of the National Institute on Aging, Bethesda, Maryland. The Women's Health and Aging Study was supported by contract NO1-AG12112 of the National Institute on Aging.
Requests for Single Reprints: Suzanne Leveille, PhD, Research and Training Institute, Hebrew Rehabilitation Center for Aged, 1200 Centre Street, Boston, MA 02131-1097; e-mail, leveille{at}mail.hrca.harvard.edu.
Current Author Addresses: Drs. Leveille and Won: Research and Training Institute, Hebrew Rehabilitation Center for Aged, 1200 Centre Street, Boston, MA 02131-1097.
Dr. Ling: Gerontology Research Center, National Institute on Aging, 5600 Nathan Shock Drive, Box 29, Baltimore, MD 21224.
Dr. Hochberg: University of Maryland, 10 South Pine Street, Medical Sschool Teaching Faculty 8-24, Baltimore, MD 21201.
Dr. Resnick: MedStar Research Institute, 108 Irving Street, Northwest Annex 5, Washington, DC 20010.
Dr. Bandeen-Roche: Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205.
Dr. Guralnik: Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, 7201 Wisconsin Avenue, Suite 3C309, Bethesda, MD 20814.
Author Contributions: Conception and design: S.G. Leveille, M. Hochberg, K. Bandeen-Roche, A. Won, J.M. Guralnik.
Analysis and interpretation of the data: S.G. Leveille, M. Hochberg, H.E. Resnick, K. Bandeen-Roche, J.M. Guralnik.
Drafting of the article: S.G. Leveille, J.M. Guralnik.
Critical revision of the article for important intellectual content: S.G. Leveille, M. Hochberg, H.E. Resnick, K. Bandeen-Roche, J.M. Guralnik.
Final approval of the article: S.G. Leveille, S. Ling, M. Hochberg, H.E. Resnick, K. Bandeen-Roche, A. Won, J.M. Guralnik.
Provision of study materials or patients: J.M. Guralnik.
Statistical expertise: S.G. Leveille, K. Bandeen-Roche, J.M. Guralnik.
Administrative, technical, or logistic support: J.M. Guralnik.
Collection and assembly of data: M. Hochberg, J.M. Guralnik.