Chronic physical illness in early life and risk of chronic widespread and regional pain at age 68: evidence from the 1946 British birth cohort.

Stella G Muthuri,Diana Kuh,Rebecca Bendayan,Rachel Cooper,Gary J Macfarlane

doi:10.1097/j.pain.0000000000000663

Stella G Muthuri, Diana Kuh + Show 3 more

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https://doi.org/10.1097/j.pain.0000000000000663

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Abstract

This study aimed to examine the associations between serious illness in earlier life and risk of pain in old age using data from a large nationally representative British birth cohort, the Medical Research Council (MRC) National Survey of Health and Development (NSHD). Serious illness was defined as any experience of illness before age 25 requiring hospital admission of ≥28 days. Pain was self-reported at age 68, with chronic widespread pain (CWP) defined according to American College of Rheumatology criteria. Multinomial logistic regression was used to test associations of serious illness in early life with CWP, chronic regional pain (CRP), and other pain, with no pain as the referent category. Adjustment was made for sex, socioeconomic position, adult health status, health behaviours, and psychosocial factors. Of 2401 NSHD participants with complete data, 10.5% reported CWP (13.2% of women and 7.7% of men), 30.2% reported CRP, and 14.8% other pain. Compared with those with no history of serious illness, those who experienced serious illness in early life had a higher likelihood of CWP (relative risk ratio [RRR] = 1.62 [95% CI: 1.21-2.17]) and of CRP (RRR = 1.25 [95% CI: 1.01-1.54]) after adjusting for sex. In fully adjusted models, serious illness in early life remained associated with CWP (RRR = 1.43 [95% CI: 1.05-1.95]), but associations with CRP were attenuated (RRR = 1.19 [95% CI: 0.96-1.48]). There were no associations with other pain. These findings suggest that those who have experienced serious illness in earlier life may require more support than others to minimise their risk of CWP in later life.

Highlights

With continued improvements in biomedical therapies and public heath, a growing number of people who have experienced chronic illnesses in early life are surviving into midlife and beyond.[31,38] These people are vulnerable to a disproportionate burden of morbidity and disability during adulthood.[4,20,21,35] With the increases in life expectancy of these and other higher risk groups, the characteristics of the adult population 65 years and older are becoming increasingly heterogeneous
Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. a Medical Research Council (MRC) Unit for Lifelong Health and Ageing, UCL, London, United Kingdom, b Epidemiology Group, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom, c Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, United Kingdom
Our findings build on those from previous studies of younger populations examining the relationship between hospitalisation in early life and chronic widespread pain (CWP)

Summary

Introduction

With continued improvements in biomedical therapies and public heath, a growing number of people who have experienced chronic illnesses in early life are surviving into midlife and beyond.[31,38] These people are vulnerable to a disproportionate burden of morbidity and disability during adulthood.[4,20,21,35] With the increases in life expectancy of these and other higher risk groups, the characteristics of the adult population 65 years and older are becoming increasingly heterogeneous. Understanding the long-term impact of chronic childhood illnesses is necessary for planning effective health and social care for older people. It. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. A MRC Unit for Lifelong Health and Ageing, UCL, London, United Kingdom, b Epidemiology Group, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom, c Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, United Kingdom

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