Back pain and heart failure in community-dwelling older adults: Findings from the Health ABC study

Chen, Jie; Zhang, Yiming; Simonsick, Eleanor M.; Starkweather, Angela; Chen, Ming Hui; McCauley, Paula; Chyun, Deborah; Cong, Xiaomei

doi:10.1016/j.gerinurse.2021.03.016

Cited by 6 publications

(4 citation statements)

References 46 publications

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“…The negative impacts of pain and HF on health outcomes among older adults were declared in our previous study. Both back pain and HF negatively impact health outcomes, including worse depressive symptoms and fatigue and declined physical function and performance 44 . Care integration is essential for the self-management of pain and HF, especially in older adults with MCCs 45 .…”

Section: Discussionmentioning

confidence: 99%

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Pain sensation and gut microbiota profiles in older adults with heart failure

Chen

Wang

Starkweather

et al. 2023

Interdisciplinary Nursing Research

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Objectives: Patients with heart failure (HF) experience severe pain and may have altered pain sensation; however, the underlying mechanisms of these symptoms are not yet fully understood. Identifying pain sensation and genomic biomarkers of pain in older adults with HF is a critical step toward developing personalized interventions to improve pain management and outcomes. This study aimed to investigate the differences in pain sensation, gut microbiota, self-reported pain, and symptoms in older adults with and without HF. Methods: Twenty older adults with HF and age-matched healthy controls (HCs) were recruited in the Northeastern United States. Quantitative sensory testing and conditioned pain modulation were performed on the nondominant upper arm to detect the mechanical, thermal, and pressure pain thresholds and pain modulations. Stool samples were collected, and the 16S rRNA V4 gene region of stool samples was sequenced and processed using the Mothur 1.42.3 pipeline. Self-reported pain and symptoms were measured by the Brief Pain Inventory and the NIH Patient-reported Outcomes Measurement Information System. The associations between pain sensation, gut microbiota α-diversity indices, and pain and symptoms were explored using the Spearman correlations. Results: The HF and HC subjects' mean ages were 73.50 (SD = 8.33) and 67.10 (SD = 7.64), respectively. The HF subjects reported significantly higher pain intensity and interference, sleep disturbance, fatigue, anxiety, and depression than the HCs. The HF subjects also had a significantly lower level of physical function and participation in social roles and activities. Compared with the HCs, the HF subjects had significantly altered conditioned pain modulation heat effect and gut microbiota compositions and predicted metabolic functions. The Statistical Analysis Of Metagenomic Profiles indicated that the HF subjects had a significantly decreased cardiac muscle contraction pathway compared with the HCs. The correlation analysis showed that the quantitative sensory testing profiles and gut microbiota diversity index were significantly associated with pain and symptoms in older adults with HF. Conclusions: Older adults with HF had more severe self-reported pain and symptoms, altered pain sensation, and different gut microbiota composition and function compared with age-matched HCs. Pain sensation and gut microbiota may contribute to pain and symptoms in older adults with HF and could serve as biomarkers of pain and symptoms of HF. Further research with a larger sample size is warranted to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

“…As more than 60% of older adults in the United States experience pain in at least one site, pain management is a crucial component of care integration. In addition, pain has been significantly associated with polypharmacy 44 , 46 .…”

Section: Discussionmentioning

confidence: 99%

Pain sensation and gut microbiota profiles in older adults with heart failure

Chen

Wang

Starkweather

et al. 2023

Interdisciplinary Nursing Research

Self Cite

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“…High prevalence of pain in the lower extremities has also been reported by Goodlin et al (2012), where the most common site of pain was the legs below the knees (32.3%). Chen et al (2021) found prevalent back pain to be associated with an increased level of fatigue, depressive symptoms, and decreased physical function among older adults with HF, illustrating the impact of noncardiac pain on the symptom burden. The primary cause of HF might be important for the location and other features of pain.…”

Section: Discussionmentioning

confidence: 99%

“…Despite this, there is sparse knowledge of the consequences of CWP on physical health and mortality. Research has suggested that disabling pain, which may be relevant for many subjects with HF, leads to a lifestyle characterized by factors associated with increased mortality risk and comprising self-care, such as lower levels of physical activity, sleeping problems, and unfavourable nutritional habits (Chen et al, 2021;Fayaz et al, 2016;Vandenkerkhof et al, 2011). Further, pain may negatively affect medication adherence, an important clinical issue highlighted in HF-guidelines (McDonagh et al, 2021).…”

Section: Prevalence Of Pain In Heart Failurementioning

confidence: 99%

Prevalence of chronic pain and chronic widespread pain among subjects with heart failure in the general population: The HUNT study

Vikan,

Landmark,

Gjeilo

2023

European Journal of Pain

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BackgroundPain in chronic heart failure (HF) is a significant but often unrecognized symptom. Characteristics of pain in subjects with HF are largely undescribed. The study aimed to address a knowledge gap in the relationship between HF and pain by investigating the prevalence of chronic pain and chronic widespread pain (CWP) among subjects with HF.MethodsPopulation data from the HUNT3 study in Norway (2006–2008, n = 50,802) was used. HF was measured by self‐report. CWP was defined as having pain in both sides of the body, pain in the upper and lower limbs, and axial pain for at least 3 months in the last year. Associations between HF and CWP and HF and moderate to high pain intensity were analysed with logistic regression.ResultsAmong subjects with HF in the general population, the prevalence of chronic pain was 67.8%, 20.7% had CWP, and 58.8% had moderate to high intensity pain. Compared to participants with cardiovascular disease but not HF, the odds of both CWP (OR = 1.6; 95% CI: 1.3–2.0) and moderate to high intensity pain (OR = 1.3; 95% CI: 1.3–1.8) were higher among participants with HF‐controlled for age, sex, body mass index, and comorbidity.ConclusionsOur study confirmed the high prevalence of pain among HF subjects. This pain could not be explained by comorbidity or sociodemographic factors, which are relevant for clinical and research purposes. Pain management should not be restricted to cardiac‐related pain but to chronic pain in general.SignificanceThis epidemiological study corroborates previous studies reporting a high prevalence of pain in the HF‐population. We found that the relationship between HF, CWP, and pain intensity could not be explained by comorbidity or sociodemographic factors, illustrating the burden of chronic pain related to HF. Our results expand the understanding of pain in HF and highlight the need to identify and manage chronic pain among individuals with HF, as widespread pain adds to the symptom burden in individuals with HF.

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Exercise training and depression and anxiety in musculoskeletal pain patients: a meta-analysis of randomized control trials

Amiri

2022

Neuropsychiatr

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Back pain and heart failure in community-dwelling older adults: Findings from the Health ABC study

Cited by 6 publications

References 46 publications

Pain sensation and gut microbiota profiles in older adults with heart failure

Pain sensation and gut microbiota profiles in older adults with heart failure

Prevalence of chronic pain and chronic widespread pain among subjects with heart failure in the general population: The HUNT study

Exercise training and depression and anxiety in musculoskeletal pain patients: a meta-analysis of randomized control trials

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