The Mediating Effect of Chronic Pain on the Relationship Between Obesity and Physical Function and Disability in Older Adults

• Autores: Angela Fowler Brown, Christina C. Wee, Edward R. Marcantonio, Long H. Ngo, Suzanne G. Leveille
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 61, Nº. 12, 2013, págs. 2079-2086
• Idioma: inglés
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• Resumen

  • Objectives: To determine the extent to which bodily pain mediates the effect of obesity on disability and physical function.

    Design: Cross-sectional analysis.

    Setting: Population-based sample of residents in the greater Boston area.

    Participants: Community-dwelling adults aged 70 and older (N = 736).

    Measurements: Body mass index (BMI), obtained from measured height and weight, was categorized as normal weight (19.0�24.9 kg/m2), overweight (25.0�29.9 kg/m2), or obese (?30.0 kg/m2). Main outcome measures were the Physical Component Summary of the Medical Outcomes Study 12-item Short-Form Survey (PCS), activity of daily living (ADL) disability, and Short Physical Performance Battery (SPPB) score. Chronic pain was assessed according to the number of weight-bearing joint sites that had pain (hips, knees, feet and pain all over).

    Results: Older obese adults had greater ADL disability and lower SPPB and PCS scores than their nonobese counterparts, although in sex-stratified adjusted analyses, obesity was adversely associated with outcomes only in women. Obesity was associated with greater number of pain sites; and more pain sites were associated with greater odds of disability. Mediation analysis suggests that pain is a significant mediator (22�44%) of the adverse effect of obesity on disability and physical function in women.

    Conclusion: Bodily pain may be an important treatable mediator of the adverse effect of obesity on disability and physical function in women.