Mechanisms of association between obesity and chronic pain in the elderly.

Abstract:

:Chronic pain is more common in the elderly and impairs functioning and quality of life. Though obesity, defined by body mass index (BMI), has been associated with pain prevalence among older adults, the mechanism of this association remains unclear. We examined components of the metabolic syndrome, insulin resistance, a marker of inflammation, and the presence of painful comorbidities as possible mediators of this association. Participants were 407 individuals aged >70 in the Einstein Aging Study. Chronic pain and pain over the last 3 months were defined using the Total Pain Index (TPI). Insulin resistance was modeled as fasting insulin, HOMA and QUICKI. High sensitivity C-reactive protein was used as a marker of inflammation. Cross-sectional logistic regression models were constructed to assess the associations of these factors with prevalent pain, adjusted for other known pain correlates. Prevalence of chronic pain was 52%. Of the clinical components of metabolic syndrome, central obesity was significantly associated with pain (OR 2.03, 95% CI 1.36-3.01). After adjustment for insulin resistance, inflammation, and pain-related comorbidities, central obesity predicted higher TPI scores (OR 1.55, 95% CI 1.04-2.33) and nearly doubled the risk of chronic pain (OR 1.70, 95% CI 1.05-2.75). Central obesity is the metabolic syndrome component showing the strongest independent association with pain, and the relationship is not explained by markers of insulin resistance or inflammation, nor by the presence of osteoarthritis or neuropathy.

journal_name

Pain

journal_title

Pain

authors

Ray L,Lipton RB,Zimmerman ME,Katz MJ,Derby CA

doi

10.1016/j.pain.2010.08.043

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

53-59

issue

1

eissn

0304-3959

issn

1872-6623

pii

00006396-201101000-00013

journal_volume

152

pub_type

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