Dataset Information

Social Support and Pain Outcomes After Trauma Exposure Among Older Adults: A Multicenter Longitudinal Study.

ABSTRACT: OBJECTIVES:Certain forms of social support have been shown to improve pain-coping behaviors and pain outcomes in older adults with chronic pain, but little is known about the effect of social support on pain outcomes in older adults following trauma exposure. METHODS:We analyzed data from a prospective longitudinal study of adults aged 65 years and older presenting to an emergency department after a motor vehicle collision (MVC) to characterize the relationship between perceived social support and MVC-related pain after trauma overall and by subgroups based on sex, depressive symptoms, and marital status. RESULTS:In our sample (N=176), patients with low perceived social support had higher pain severity 6 weeks after MVC than patients with high perceived social support after adjustment for age, sex, race, and education (4.2 vs. 3.2, P=0.04). The protective effect of social support on pain severity at 6 weeks was more pronounced in men and in married individuals. Patients with low social support were less likely to receive an opioid prescription in the emergency department (15% vs. 32%, P=0.03), but there was no difference in opioid use at 6 weeks (22% vs. 20%, P=0.75). DISCUSSION:Among older adults experiencing trauma, low perceived social support was associated with higher levels of pain at 6 weeks.

SUBMITTER: Richmond NL

PROVIDER: S-EPMC5837905 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Social Support and Pain Outcomes After Trauma Exposure Among Older Adults: A Multicenter Longitudinal Study.

Richmond Natalie L NL Meyer Michelle L ML Hollowell Allison G AG Isenberg Erin E EE Domeier Robert M RM Swor Robert A RA Hendry Phyllis L PL Peak David A DA Rathlev Niels K NK Jones Jeffrey S JS Lee David C DC Jones Christopher W CW Platts-Mills Timothy F TF

The Clinical journal of pain 20180401 4

<h4>Objectives</h4>Certain forms of social support have been shown to improve pain-coping behaviors and pain outcomes in older adults with chronic pain, but little is known about the effect of social support on pain outcomes in older adults following trauma exposure.<h4>Methods</h4>We analyzed data from a prospective longitudinal study of adults aged 65 years and older presenting to an emergency department after a motor vehicle collision (MVC) to characterize the relationship between perceived s ...[more]

PMID: 28915155

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Project description:ImportanceOlder adults who live alone are at risk for poor health outcomes. Whether social support mitigates the risk of living alone, particularly when facing a sudden change in health, has not been adequately reported.ObjectiveTo assess if identifiable support buffers the vulnerability of a health shock while living alone.Design, setting, and participantsIn this longitudinal, prospective, nationally representative cohort study from the Health and Retirement Study (enrollment March 2006 to April 2015), 4772 community-dwelling older adults 65 years or older who lived alone in the community and could complete activities of daily living (ADLs) and instrumental ADLs independently were followed up biennially through April 2018. Statistical analysis was completed from May 2020 to March 2021.ExposuresIdentifiable support (ie, can the participant identify a relative/friend who could help with personal care if needed), health shock (ie, hospitalization, new diagnosis of cancer, stroke, heart attack), and interaction (multiplicative and additive) between the 2 exposures.Main outcomes and measuresThe primary outcomes were incident ADL dependency, prolonged nursing home stay (≥30 days), and death.ResultsOf 4772 older adults (median [IQR] age, 73 [68-81] years; 3398 [71%] women) who lived alone, at baseline, 1813 (38%) could not identify support, and 3013 (63%) experienced a health shock during the study. Support was associated with a lower risk of a prolonged nursing home stay at 2 years (predicted probability, 6.7% vs 5.2%; P = .002). Absent a health shock, support was not associated with a prolonged nursing home stay (predicted probability over 2 years, 1.9% vs 1.4%; P = .21). However, in the presence of a health shock, support was associated with a lower risk of a prolonged nursing home stay (predicted probability over 2 years, 14.2% vs 10.9%; P = .002). Support was not associated with incident ADL dependence or death.Conclusions and relevanceIn this longitudinal cohort study among older adults who live alone, identifiable support was associated with a lower risk of a prolonged nursing home stay in the setting of a health shock.

Project description:ObjectivesThis study aimed to describe gait speed at admission and discharge from inpatient hospital rehabilitation among older adults recovering from orthopaedic trauma and factors associated with gait speed performance and discharge destination.DesignA longitudinal cohort study was conducted.SettingAustralian tertiary hospital subacute rehabilitation wards.ParticipantsPatients aged ?60 years recovering from orthopaedic trauma (n=746, 71% female) were eligible for inclusion.InterventionsUsual care (multidisciplinary inpatient hospital rehabilitation).Primary and secondary outcome measuresGait speed was assessed using the timed 10 m walk test. The proportion of patients exceeding a minimum gait speed threshold indicator (a priori 0.8 m/s) of community ambulation ability was calculated. Generalised linear models were used to examine associations between patient and clinical factors with gait speed performance and being discharged to a residential aged care facility.ResultsAt discharge, 18% of patients (n=135) exceeded the 0.8 m/s threshold indicator for community ambulation ability. Faster gait speed at discharge was found to be associated with being male (B=0.43, 95%?CI -0.01 to 0.87), admitted with pelvic (B=0.76, 95%?CI 0.14 to 1.37) or multiple fractures (B=1.13, 95%?CI 0.25 to 2.01) (vs hip fracture), using no mobility aids (B=-0.93, 95%?CI -1.89 to 0.01) and walking at a faster gait speed at admission (B=5.77, 95%?CI 5.03 to 6.50). Factors associated with being discharged to residential aged care included older age (OR 1.06, 95%?CI 1.03 to 1.10), longer length of stay (OR 1.01, 95%?CI 1.01 to 1.02), having an upper limb fracture (vs hip fracture) (OR 2.81, 95%?CI 1.32 to 5.97) and lower Functional Independence Measure cognitive score (OR 0.89, 95%?CI 0.86 to 0.92).ConclusionsPatients with a range of injury types, not only those presenting to hospital with hip fractures, are being discharged with slow gait speeds that are indicative of limited functional mobility and a high risk of further adverse health events.

Project description:Importance:Cataract-related vision impairment is an important public health issue that tends to affect older adults. Little is known about the association between older adults' social support networks and their likelihood of receiving cataract surgery. Objective:To determine if older adults with smaller social support networks are less likely to receive cataract surgery. Design, Setting, and Participants:Retrospective cohort study. The National Health and Aging Trends Study, a nationally representative US survey, administered annually from 2011 to 2015 to a cohort of Medicare beneficiaries 65 years and older with no cataract surgery prior to the start of the study. Main Outcomes and Measures:Multivariable logistic regression was performed to evaluate if the number of persons in an individual's social support network influenced whether that individual received cataract surgery during a given year of the study. Results:Overall, 3448 participants were interviewed from 2011 to 2015 for a total of 9760 observations. Of these observations, 3084 (weighted, 38.81%; 95% CI, 37.28-40.35) were aged 70 to 74 years, 5211 (weighted, 52.32%; 95% CI, 50.19-54.44) were women; 5899 (weighted, 78.53%; 95% CI, 76.29-80.61) were white, 2249 (weighted, 9.55%; 95% CI, 8.45-10.78) were black, 537 (weighted, 7.18%; 95% CI, 5.88-8.73) were Hispanic, and 303 (weighted, 4.74%; 95% CI, 3.56-62.9) reported other races. Medicare beneficiaries with smaller social support networks (0-2 individuals) were less likely to receive cataract surgery in a given year (adjusted odds ratio, 0.60; 95% CI, 0.37-0.96) than those with larger support networks (≥3 individuals). The adjusted predicted proportion of Medicare beneficiaries undergoing cataract surgery was 4.7% (95% CI, 2.7%-6.7%) and 7.5% (95% CI, 6.9%-8.1%) for those with small and large social support networks, respectively. Having fewer non-spouse/partner family members in the support network was associated with decreased odds of receiving cataract surgery (adjusted odds ratio, 0.60; 95% CI, 0.43-0.85), but having spouses/partners (adjusted odds ratio, 0.97; 95% CI, 0.77-1.22) and nonfamily members (adjusted odds ratio, 0.90; 95% CI, 0.72-1.11) did not have a significant association. Conclusions and Relevance:Medicare beneficiaries with fewer non-spouse/partner family members in their social support networks were less likely to receive cataract surgery. These findings suggest that attention should be given to patients with smaller support networks to ensure that they receive cataract surgery when it is indicated.

Dataset Information

Social Support and Pain Outcomes After Trauma Exposure Among Older Adults: A Multicenter Longitudinal Study.

Publications

Social Support and Pain Outcomes After Trauma Exposure Among Older Adults: A Multicenter Longitudinal Study.

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