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

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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.

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Data availability

All data is available per written individual request to University of Alabama at Birmingham (UAB). Code availability: Any software programming code is available per written individual request to UAB.

Code availability

Any software programming code is available per written individual request to University of Alabama at Birmingham (UAB).

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Funding

Supported in part by the National Institutes of Health (K08CA234225 – GW). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, 1600 7th Avenue South, Lowder 500, Birmingham, AL, 35233, USA

    Mustafa AL-Obaidi, Christian Harmon, Smita Bhatia, Smith Giri & Grant R. Williams

  2. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA

    Sarah Kosmicki & Gerald McGwin

  3. Department of Neurology, Division of Neuro-Oncology, University of Alabama at Birmingham, Birmingham, AL, USA

    Mina Lobbous

  4. O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA

    Darryl Outlaw, Moh’d Khushman, Smita Bhatia, Smith Giri & Grant R. Williams

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  1. Mustafa AL-Obaidi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Grant R. Williams, Mustafa AL-Obaidi, and Sarah Kosmicki, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mustafa AL-Obaidi.

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Ethical considerations were presented to and approved by the UAB IRB per review. Study subjects were determined to be exposed to minimal risk.

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All enrolled participants have been consented by IRB-approved study personnel, according to UAB IRB rules and regulations.

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AL-Obaidi, M., Kosmicki, S., Harmon, C. et al. Pain among older adults with gastrointestinal malignancies- results from the cancer and aging resilience evaluation (CARE) Registry. Support Care Cancer 30, 9793–9801 (2022). https://doi.org/10.1007/s00520-022-07398-4

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