Study identifies four distinct pain trajectories in nursing home residents

Medical Xpress / Regenstrief Institute / Journal of the American Geriatrics Society ^ | Feb. 27, 2023 | Connie S. Cole et al

[ConservativeMind]

Despite awareness that pain is common in nursing home residents, there has been minimal attention focused on how this pain changes over time. A new study presents compelling evidence of the existence of four distinct pain trajectories in this population.

"Identification of pain trajectories can help us improve pain control for nursing home residents," said Connie Cole, Ph.D., DNP. "We can identify risk factors and use those to recognize individuals who are at increased risk for pain. For patients who are not able to self-report, such as someone with Alzheimer's disease, we can use those factors to identify that they might be at increased risk for pain and therefore monitor them more closely."

Persistent pain is associated with reduced quality of life and poorer health outcomes.

Researchers identified four distinct long-term pain trajectories.

- persistent pain over time (14 percent) - pain initially increasing, holding steady and then decreasing over time (15 percent) - pain initially decreasing, holding steady and then increasing over time (22 percent) - pain consistently absent (49 percent)

Among the study's numerous findings regarding risk factors associated with various pain trajectories:

Obesity and intact cognition were associated with the persistent pain presence trajectory as was living in a rurally located nursing home.

Hip fracture was associated with a five-fold increased risk of persistent pain.

Residents in the increasing-decreasing pain trajectory were at greater risk of death.

Female gender, living in a rurally located nursing home, intact cognition and contracture (a condition of shortening and hardening of muscles) were common factors associated with all three of the trajectories in which pain was present.

Nursing home residents with normal body mass index (BMI) or a diagnosis of Alzheimer's disease or related dementia were less likely to be in any of the three trajectories in which pain was present.

[ConservativeMind]

It is important we remember those in our lives who may be suffering and work to assure their needs are better cared for.

[ConservativeMind]

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