Pain and mortality among older adults in Korea

Song, Chiil; Chung, Wankyo

doi:2021.43.0.e2021058

Epidemiol Health > Volume 43; 2021 > Article

Original Article

Epidemiology and Health 2021;43: e2021058-0.
DOI: https://doi.org/10.4178/epih.e2021058 Published online Sep 7, 2021.

Pain and mortality among older adults in Korea

Chiil Song¹

, Wankyo Chung^1,2

¹Graduate School of Public Health, Seoul National University, Seoul, Korea
²Artificial Intelligence Institute, Seoul National University, Seoul, Korea

Correspondence Wankyo Chung ,Email: wankyo@snu.ac.kr

Received: May 28, 2021 Accepted after revision: Sep 7, 2021

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.

Keywords: Pain, Mortality, Proportional hazards models, Korea