Pain and disability in a group of Chinese elderly out-patients in Hong Kong

DKY Miu, TY Chan, MH Chan
Department of Medicine and Geriatrics, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong

OBJECTIVE. To investigate the relationship between musculoskeletal pain and disability among a group of geriatric out-patients.

DESIGN. Consecutive case series.

SETTING. Regional hospital, Hong Kong.

PARTICIPANTS. Attendees at a geriatric specialist out-patient clinic from October 2002 to February 2003.

MAIN OUTCOME MEASURES. Pain duration, location, intensity, and frequency; use of analgesics; ability to identify the cause of pain; disability (Barthel index) and Lawton Instrumental Activities of Daily Living scale score; depressive symptoms (Geriatric Depression Scale score); and self-reported sleep quality.

RESULTS. Of the 749 respondents, 461 (61.5%) had experienced pain in the previous 2 weeks. Among these patients, 51.3% had received a pain-relieving drug. Compared with men, women reported a higher pain intensity (5.87 versus 5.26; P=0.001), had a lower Barthel index (96.0 versus 97.9; P=0.005), and had a lower score on the Lawton Instrumental Activities of Daily Living scale (42.19 versus 44.52; P=0.008). Multivariate logistic regression showed that the presence of pain was associated with female sex (odds ratio=2.25), poor self-rated
health (0.69), and depression (1.54).

CONCLUSION. Pain is a common problem among the elderly population, but it is not associated with physical disability, and only half of the patients received analgesics. The study provides information for health care workers to develop strategies to better assess and manage pain problems among elderly people.

Hong Kong Med J 2004;10:160-5

Key words: Aged; Disability evaluation; Musculoskeletal diseases; Pain; Sex factors