Comorbid Pain and Cognitive Impairment in a Nationally Representative Adult Population
| Autor: | Richard L. Nahin, Steven T. DeKosky |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Health Status MEDLINE Personal Satisfaction Logistic regression Article 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Internal medicine Health care Prevalence Humans Medicine Dementia National Health Interview Survey Cognitive Dysfunction Cognitive impairment business.industry Chronic pain Patient Acceptance of Health Care medicine.disease United States Integrated care Cross-Sectional Studies Anesthesiology and Pain Medicine Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Clin J Pain |
| ISSN: | 0749-8047 |
| DOI: | 10.1097/ajp.0000000000000863 |
| Popis: | OBJECTIVE Using a nationally representative sample of adults and pain definitions consistent with the United States National Pain Strategy, we examined the associations of pain and cognitive impairment (CI) with each other and with measures of health status, physical impairment, social impairment, health care utilization, and dissatisfaction with health care. MATERIALS AND METHODS Prevalence estimates and multivariable logistic regression analyses of the 2017 National Health Interview Survey were performed. RESULTS As the level of reported pain increased from "no pain" to high-impact chronic pain (HICP), there was an increase in the prevalence of CI from 2.99% in those with no pain to 18.19% in those with HICP. Similarly, as the level of CI increased from no impairment to substantial CI, the prevalence of any pain increased from 62.44% to 83.20%. As pain severity and CI increased, we found increased prevalence for all outcomes examined, with the highest prevalence seen in participants with HICP and substantial CI. While 4.15% of individuals without either pain or CI reported poor/fair health, this increased to 33.98% in those with substantial CI or "dementia" but no pain, to 52.22% in those with HICP but no CI, and to 81.8% in individuals reporting both HICP and substantial CI or "dementia." DISCUSSION Our data suggest that individuals with comorbid chronic pain and CI are in a much higher state of self-reported disability than those with chronic pain or CI alone. Best practice guidelines are generally silent on multidisciplinary, integrated care for these comorbid conditions, increasing the potential for inadequate care. |
| Databáze: | OpenAIRE |
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