Chronic Musculoskeletal Pain, Self-Reported Health and Quality of Life among Older Populations in South Africa and Uganda.

Chao Wang,Shangfeng Tang,Bishwajit Ghose,Run Pu

doi:10.3390/ijerph15122806

Abstract

Chronic musculoskeletal pain (CMP) is a serious health concern especially among the elderly population and has significant bearing on health and quality of life. Not much is known about the relationship between chronic pain with self-reported health and quality of life among older populations in low-resource settings. Based on sub-national data from South Africa and Uganda, the present study aimed to explore whether the older population living with CMP report health and quality of life differently compared to those with no CMP complaints. This study was based on cross-sectional data on 1495 South African and Ugandan men and women collected from the SAGE Well-Being of Older People Study. Outcome variables were self-reported physical and mental health and quality of life (QoL). Mental health was assessed by self-reported depressive symptoms during the last 12 months. CMP was assessed by self-reported generalised pain as well as back pain. Multivariable logistic regression models were used to measure the association between health and QoL with CMP by adjusting for potential demographic and environmental confounders. The prevalence of poor self-rated health (61.2%, 95% CI = 51.7, 70.0), depression (37.2%, 95% CI = 34.8, 39.6) and QoL (80.5%, 95% CI = 70.8, 87.5) was considerably high in the study population. Mild/moderate and Severe/extreme generalised pain were reported respectively by 34.5% (95% CI = 28.9, 40.5) and 15.7% (95% CI = 12.2, 19.9) of the respondents, while back pain was reported by 53.3% (95% CI = 45.8, 60.4). The prevalence of both types was significantly higher among women than in men (p < 0.001). In the multivariate analysis, both generalised pain and back pain significantly predicted poor health, depression and QoL, however, it varied between the two different populations. Back pain was associated with higher odds of poor self-rated health [OR = 1.813, 95% CI = 1.308, 2.512], depression [1.640, 95% CI = 1.425, 3.964] and poor QoL [1.505, 95% CI = 1.028, 2.202] in South Africa, but not in Uganda. Compared to having no generalised pain, having Mild/Moderate [OR = 2.309, 95% CI = 1.219, 7.438] and Severe/Extreme [OR = 2.271, 95% CI = 1.447, 4.143] generalised pain was associated with significantly higher odds of poor self-rated health in South Africa. An overwhelmingly high proportion of the sample population reported poor health, quality of life and depression. Among older individuals, health interventions that address CMP may help promote subjective health and quality and life and improve psychological health.

Highlights

In the Western countries, non-specific chronic musculoskeletal pain (CMP) represents one of the most common causes of functional disability and of medical visits among adults [1,2,3,4].Among the elderly, CMP is a major reason for medical consultations, and those living with CMP report poor physical and psychological health as well as low satisfaction with quality of life [4,5,6].CMP is an umbrella term and generally encompasses all forms of musculoskeletal pain e.g., general acute pain and chronic skeletal pain
The findings indicated that suffering from generalised pain and back pain can significantly reduce health and quality of life (QoL) and increase perceived depression in both countries
We found a considerably high prevalence of poor self-reported quality of life and depression among older men and women in South Africa and Uganda, with the overall prevalence of depression being higher among men compared with women

Summary

Introduction

In the Western countries, non-specific chronic musculoskeletal pain (CMP) represents one of the most common causes of functional disability and of medical visits among adults [1,2,3,4].Among the elderly, CMP is a major reason for medical consultations, and those living with CMP report poor physical and psychological health as well as low satisfaction with quality of life [4,5,6].CMP is an umbrella term and generally encompasses all forms of (non-cancer) musculoskeletal pain e.g., general acute pain and chronic skeletal pain. In the Western countries, non-specific chronic musculoskeletal pain (CMP) represents one of the most common causes of functional disability and of medical visits among adults [1,2,3,4]. CMP is a major reason for medical consultations, and those living with CMP report poor physical and psychological health as well as low satisfaction with quality of life [4,5,6]. CMP is an umbrella term and generally encompasses all forms of (non-cancer) musculoskeletal pain e.g., general acute pain and chronic skeletal pain. CMP, especially chronic back pain (CBP), is a major debilitating factor among the elderly populations and has significant bearings on occupational productivity, health and overall well-being [7,8]. Genetic predisposition is generally believed to be a key determinant [1], but back pain has been reported to have a strong socioeconomic gradient [2,5,10], with the burden being considerably higher among those in lower social strata and engaged in strenuous occupation e.g., heavy physical workload, prolonged lifting and carrying, and frequently twisting or bending [4,5,9,11]

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