HHS Public Access Author manuscript Author Manuscript
J Am Geriatr Soc. Author manuscript; available in PMC 2017 January 01. Published in final edited form as: J Am Geriatr Soc. 2016 January ; 64(1): 138–143. doi:10.1111/jgs.13869.
Effect of Pain and Mild Cognitive Impairment on Mobility Caroline A. Schepker, DO1,2,3, Suzanne G. Leveille, PhD, RN4,8, Mette M. Pedersen, MHSc1,5, Rachel E. Ward, PhD1,2,7, Laura A. Kurlinski, BA1, Laura Grande, PhD6, Dan K. Kiely, MPH, MA1, and Jonathan F. Bean, MD, MS, MPH9,1,2 1
Spaulding Rehabilitation Hospital, Boston, Massachusetts
2
Author Manuscript
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts 3
Touro University California College of Osteopathic Medicine, Vallejo, California
4
Department of Nursing, UMass Boston, Boston, Massachusetts
5
Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
6
Psychology Service, VA Boston Healthcare System, Boston MA and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
7
School of Public Health, Boston University, Boston, Massachusetts
8
Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
Author Manuscript
9
New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts
Abstract Background/Objectives—Pain, mild cognitive impairment (MCI), and mobility limitations are common among older adults. The separate and combined effect of pain and MCI on mobility has not yet been elucidated. This study examines the associations of pain and MCI on performancebased and patient-reported mobility outcomes among older primary care patients with mild-tomoderate self-reported mobility limitations. Design—Cross-sectional analysis.
Author Manuscript
Setting—Academic community outpatient clinic. Participants—430 primary care patients aged ≥ 65 years at risk for mobility decline enrolled in the Boston Rehabilitative Impairment Study in the Elderly. Measurements—The Brief Pain Inventory (BPI) identified participants with an average score of >3 with pain. MCI was defined using age-adjusted scores on a neuropsychological battery. Multivariable linear regression models assessed associations between Pain/MCI status and mobility performance (habitual gait speed, the Short Physical Performance Battery), and patient reports (Late Life Function and Disability Instrument [LLFDI]).
Corresponding author: Caroline A. Schepker; [email protected]; Phone: (860) 490-7823; Fax: (617) 952-6801.
Schepker et al.
Page 2
Author Manuscript
Results—The prevalence of pain and MCI were 34% and 42%, respectively. Pain only and MCI only were present among 17% and 25%, respectively. Both pain and MCI was present in 17%; 41% had neither condition. Participants with both pain and MCI performed significantly worse than all others on all mobility outcomes (p
J Am Geriatr Soc. Author manuscript; available in PMC 2017 January 01. Published in final edited form as: J Am Geriatr Soc. 2016 January ; 64(1): 138–143. doi:10.1111/jgs.13869.
Effect of Pain and Mild Cognitive Impairment on Mobility Caroline A. Schepker, DO1,2,3, Suzanne G. Leveille, PhD, RN4,8, Mette M. Pedersen, MHSc1,5, Rachel E. Ward, PhD1,2,7, Laura A. Kurlinski, BA1, Laura Grande, PhD6, Dan K. Kiely, MPH, MA1, and Jonathan F. Bean, MD, MS, MPH9,1,2 1
Spaulding Rehabilitation Hospital, Boston, Massachusetts
2
Author Manuscript
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts 3
Touro University California College of Osteopathic Medicine, Vallejo, California
4
Department of Nursing, UMass Boston, Boston, Massachusetts
5
Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
6
Psychology Service, VA Boston Healthcare System, Boston MA and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
7
School of Public Health, Boston University, Boston, Massachusetts
8
Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
Author Manuscript
9
New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts
Abstract Background/Objectives—Pain, mild cognitive impairment (MCI), and mobility limitations are common among older adults. The separate and combined effect of pain and MCI on mobility has not yet been elucidated. This study examines the associations of pain and MCI on performancebased and patient-reported mobility outcomes among older primary care patients with mild-tomoderate self-reported mobility limitations. Design—Cross-sectional analysis.
Author Manuscript
Setting—Academic community outpatient clinic. Participants—430 primary care patients aged ≥ 65 years at risk for mobility decline enrolled in the Boston Rehabilitative Impairment Study in the Elderly. Measurements—The Brief Pain Inventory (BPI) identified participants with an average score of >3 with pain. MCI was defined using age-adjusted scores on a neuropsychological battery. Multivariable linear regression models assessed associations between Pain/MCI status and mobility performance (habitual gait speed, the Short Physical Performance Battery), and patient reports (Late Life Function and Disability Instrument [LLFDI]).
Corresponding author: Caroline A. Schepker; [email protected]; Phone: (860) 490-7823; Fax: (617) 952-6801.
Schepker et al.
Page 2
Author Manuscript
Results—The prevalence of pain and MCI were 34% and 42%, respectively. Pain only and MCI only were present among 17% and 25%, respectively. Both pain and MCI was present in 17%; 41% had neither condition. Participants with both pain and MCI performed significantly worse than all others on all mobility outcomes (p
