Pain among older adults with gastrointestinal malignancies- results from the cancer and aging resilience evaluation (CARE) Registry

Mustafa Al-Obaidi; Sarah Kosmicki; Christian Harmon; Mina Lobbous; Darryl Outlaw; Moh'd Khushman; Gerald McGwin; Smita Bhatia; Smith Giri; Grant R Williams

doi:10.1007/s00520-022-07398-4

Pain among older adults with gastrointestinal malignancies- results from the cancer and aging resilience evaluation (CARE) Registry

Support Care Cancer. 2022 Dec;30(12):9793-9801. doi: 10.1007/s00520-022-07398-4. Epub 2022 Nov 4.

Authors

Mustafa Al-Obaidi¹, Sarah Kosmicki², Christian Harmon³, Mina Lobbous⁴, Darryl Outlaw⁵, Moh'd Khushman⁵, Gerald McGwin², Smita Bhatia^{3

5}, Smith Giri^{3

5}, Grant R Williams^{3

5}

Affiliations

¹ Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, 1600 7th Avenue South, Lowder 500, Birmingham, AL, 35233, USA. mustafalobaidi@yahoo.com.
² Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
³ Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, 1600 7th Avenue South, Lowder 500, Birmingham, AL, 35233, USA.
⁴ Department of Neurology, Division of Neuro-Oncology, University of Alabama at Birmingham, Birmingham, AL, USA.
⁵ O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.

PMID: 36329186
DOI: 10.1007/s00520-022-07398-4

Abstract

Purpose: The impact of pain on functional status and mental health among older adults with cancer is a relevant, yet understudied. We sought to identify the prevalence of pain at diagnosis in older adults with gastrointestinal (GI) malignancies and evaluate the association of pain with functional status limitations, cognition, and mental health.

Methods: This prospective cross-sectional study included older adults (age ≥ 60) with GI cancers enrolled in the CARE Registry. Pain measured in numeric rating scale from 0 to 10. We utilized the literature based cutoff for moderate-severe as ≥ 4. Logistic regression used to assess differences in functional status, falls, cognitive complaints, and depression/anxiety associated with moderate/severe pain, adjusted for sex, race, education, ethnicity, marital status, cancer type/stage, and treatment phase.

Results: Our cohort included 714 older adults with an average mean age of 70 years and 59% male. Common diagnoses included colorectal (27.9%) and pancreatic (18%). A total of 43.3% reported moderate/severe pain. After multivariate adjusting for covariates, participants with self-reported moderate/severe pain were more likely to report limitations in instrumental activities of daily living (adjusted odds ratio [aOR] 4.3 95% confidence interval [CI] 3.1-6.1, p < .001), limitation in activities of daily living (aOR 3.2 95% CI 2.0-5.1, p < .001), cognitive complaints (aOR 2.9 95% CI 1.4-6.0, p < .004), anxiety (aOR 2.2 95% CI 1.4-3.4, p < 0.01), and depression (aOR 3.7 95% CI 2.2-6.5, p < .001).

Conclusions: Pain is common among older adults with GI cancers and is associated with functional status limitations, cognitive complaints, and depression/anxiety. Strategies to reduce pain and minimize its potential impact on function and mental health warrant future research.

Keywords: Aging; Anxiety; Cancer; Depression; Functional status; Geriatric assessment; Geriatric oncology; Mental health; Pain.

MeSH terms

Activities of Daily Living* / psychology
Aged
Aging
Cross-Sectional Studies
Female
Gastrointestinal Neoplasms* / complications
Gastrointestinal Neoplasms* / epidemiology
Humans
Male
Pain / epidemiology
Pain / etiology
Prospective Studies
Registries

Abstract

MeSH terms

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