Pain and Its Impact on Functional Health: 7-Year Longitudinal Findings among Middle-Aged and Older Adults in Indonesia

Vasoontara Sbirakos Yiengprugsawan,John Piggott,Firman Witoelar,Fiona M Blyth,Robert G Cumming

doi:10.3390/geriatrics5020039

Abstract

Pain is a growing public health issue worldwide, but there is limited population-based evidence in low- and middle-income country settings. Using nationwide Indonesian Family Life Survey (IFLS) data in 2007 and 2014, this research sets out to investigate the associations between changes in pain status between two time points and its impact on functional health outcomes among middle-aged and older adults in Indonesia. Analyses focused on 7936 adults aged 50 years and older in 2014 who responded to both waves. Functional health was assessed using a composite score of functional limitations (range 20–100), representing difficulty in performing activities of daily living, and grip strength (kilograms). Multivariate linear regression models were used to analyse associations between pain measured in 2007 and 2014 and functional health in 2014. Severe pain in the latest wave of IFLS was associated with older age, female, lower education, having chronic conditions or depressive symptoms. Notably, those who reported ‘low–medium’ pain in 2007 and ‘severe’ pain in 2014 belonged to the most vulnerable group with worst functional health outcomes (4.96 points higher limitation scores and 1.17 kg weaker average grip strength). Findings have implications for public health policy in monitoring and management of pain including related co-morbidities as an increasingly critical component of population ageing.

Highlights

Pain is an increasingly common phenomenon over the lifetime of a person [1,2].Pain, when persistent, directly impacts the physical and psychological wellbeing of individuals and could have implications for health service use and social support systems [3,4,5]
Severe pain in the latest wave of Indonesian Family Life Survey (IFLS) (2014) was more common among females (12.3% compared to 7.7% across all age groups and 15.6% vs. 9.7% among middle-aged and older adults) (Table 1)
Respondents who were widowed, had up to elementary school education and belonged to the lowest per capita expenditure tertile reported chronic conditions, and those with depressive symptoms had a higher proportion of severe pain both across all ages and among those aged 50 years and older

Summary

Introduction

Pain is an increasingly common phenomenon over the lifetime of a person [1,2].Pain, when persistent, directly impacts the physical and psychological wellbeing of individuals and could have implications for health service use and social support systems [3,4,5]. Pain is an increasingly common phenomenon over the lifetime of a person [1,2]. According to the Global Burden of Disease Study 1990–2017, musculoskeletal disorders comprised the second highest cause of years lived with disability, posing public health challenges in developed and developing countries [6]. These issues may become severe among older people, affecting physical functioning in daily activities, frailty, social engagement, and psychological distress [7,8]. Pain management in older persons is challenging due to other co-morbidities [5].

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Discussion

Conclusion