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1 "Proportional hazards models"
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Original Article
Pain and mortality among older adults in Korea
Chiil Song, Wankyo Chung
Epidemiol Health. 2021;43:e2021058.   Published online September 7, 2021
DOI: https://doi.org/10.4178/epih.e2021058
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
With the increasing elderly population with chronic disease, understanding pain and designing appropriate policy interventions to it have become crucial. While pain is a noted mortality risk factor, limited studies exist due to the various causes of pain and the subjectivity of pain expression. This study aimed to examine the relationship between pain and mortality, controlling for other diseases and socio-cultural factors.
METHODS
We analyzed 6,258 individuals aged 45 years or older, the population with the highest prevalence of pain, using the Korean Longitudinal Study of Aging (2006-2016) data and the Cox proportional-hazards model. Further subgroup analyses were conducted by sex and education level to examine differences in the relationship between pain and mortality.
RESULTS
The adjusted hazard ratios of mortality were 1.16 (95% confidence interval [CI], 1.00 to 1.34, model 1) and 1.12 (95% CI, 0.97 to 1.29, model 2) for the individuals in pain depending on the models used, where additional socio-cultural factors were accounted for in model 2. For individuals in severe pain, ratios were significantly higher with 1.23 (95% CI, 1.08 to 1.41, model 1) and 1.16 (95% CI, 1.02 to 1.32, model 2). Further subgroup analyses showed that severe pain was more associated with mortality for males and more educated individuals, with adjusted hazard ratios of 1.29 (95% CI, 1.08 to 1.55, model 2) and 1.62 (95% CI, 1.15 to 2.28, model 2), respectively.
CONCLUSIONS
Pain showed a statistically significant relationship with mortality risk. Family members or medical staff should pay proper attention to pain, particularly severe pain in males and highly educated individuals.
Summary
Korean summary
우리나라의 고령인구와 만성질환의 증가가 가속화됨에 따라, 통증의 문제를 겪는 인구가 증가하고 통증의 사회경제적 영향도 커지고 있어 통증에 대한 엄밀한 분석이 요구된다. 본 연구는 통증을 주로 겪는 중·고령층을 대상으로 생존분석을 통해, 통증이 객관적 지표인 사망위험과 유의미하게 관련이 있음을 보였다. 따라서 환자의 통증 표현은, 특히 남성과 고학력자의 심한 통증 표현은, 사망과 관련이 있는 중요한 지표로 관리될 필요가 있으며 적절한 정책적 접근이 요구된다.
Key Message
With the increasing elderly population with chronic disease, understanding pain and designing appropriate policy interventions to it have become crucial. This study showed that pain had a statistically significant relationship with mortality risk, thus proper attention should be paid to it.

Citations

Citations to this article as recorded by  
  • Impact of Pain on Activities of Daily Living in Older Adults: A Cross-Sectional Analysis of Korean Longitudinal Study of Aging (KLoSA)
    Ambrish Singh, Sreelatha Akkala, Minakshi Nayak, Anirudh Kotlo, Naresh Poondla, Syed Raza, Jim Stankovich, Benny Antony
    Geriatrics.2024; 9(3): 65.     CrossRef
  • Sex-specific effects of neuropathic pain on long-term pain behavior and mortality in mice
    Magali Millecamps, Susana G. Sotocinal, Jean-Sebastien Austin, Laura S. Stone, Jeffrey S. Mogil
    Pain.2023; 164(3): 577.     CrossRef
  • Spécificités de la prise en charge de la douleur chez la personne âgée
    G. Pickering
    Bulletin de l'Académie Nationale de Médecine.2023; 207(5): 661.     CrossRef

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