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Investigating Chronic Pain and Diabetes in Older Adults

May 14, 2018

Chronic pain, in addition to causing physical discomfort, is also associated with poor mobility and increased risk of early death.

Researchers M Karjalainen (University of Eastern Finland, Kuopio, Finland) and colleagues conducted a study to investigate potential associations between pain and diabetes in older adults. The findings of the study were recently published in BMC Geriatrics.

Older individuals aged 65 years or older with diabetes (527 adults) and age and gender matched controls (890 adults) were identified from electronic patient records. Frequent pain was regarded as any pain experienced more often than once a week; it was divided into pain experienced several times a week but not daily and pain experienced daily or continuously.

The researchers gave questionnaires to selected participants. The detailed questionnaires requested information on how much and what type of pain they experienced, level of physical activity, alcohol consumption and smoking, symptoms of depression, as well as any other chronic, long-term, disease that the recipient suffered from, such as heart disease or cancer.

A total of 993 recipients completed the questionnaires, including 389 diabetics and 604 nondiabetics. Of all the respondents, 75% reported feeling pain of some type, with shoulder and knee pain being the most common. Women with diabetes were 10% more likely to have experienced pain than woman who did not have diabetes. Female diabetics were also more likely to suffer from chronic pain, with 59% of diabetics suffering from chronic pain compared to only 47% of nondiabetics.

Other differences were noted between diabetics and nondiabetics besides the likelihood of feeling pain. For example, female diabetics reported experiencing more symptoms of depression than female nondiabetics. Male and female diabetics were both more likely to suffer from a greater number of additional diseases compared to their nondiabetic controls (the most common condition was high blood pressure. Diabetics of both genders reported being less physically active than nondiabetics).

When the researchers re-analyzed their data to account for these additional factors, they found that having diabetes was not a good predictor of whether or not study participants experienced pain. Instead, they found that it was actually symptoms of depression and the number of additional illnesses that were most strongly associated with pain. This was true for both men and women.

Overall, the researchers concluded that older women with diabetes were more likely to suffer from pain than non-diabetic women. However, symptoms of depression and the number of additional illnesses were better predictors of pain (2018;18:73. doi:10.1186/s12877-018-0762-y).

Authors acknowledged limitations of the study, including the need to rely on questionnaire respondents for data, the regional location of the study (limited to a semirural district in Finland), and the ability to only find associations between pain and diabetes, rather than to determine if one caused the other, due to study design.

—Amanda Del Signore

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