Investigating the Inter-Relationships between Pain, Frailty, and Depression Among Older Adults in the Community and/or Receiving Nursing Care

Title: Investigating the Inter-Relationships between Pain, Frailty, and Depression Among Older Adults in the Community and/or Receiving Nursing Care

Investigator: Matthew Lohman, PhD, MHS, Weill Cornell Medical College

Overview: This pilot study will investigate the inter-relationships between pain, frailty, and depression among older adults in the community and/or receiving nursing care. This study will undertake the specific aims detailed below using latent variable analysis and data from two complementary data sources: 1) the Health and Retirement Study (HRS), and 2) CareAnywhere/Brightree dataset, containing data collected from the Outcome and Assessment Information Set (OASIS) mandatory assessment of older adults receiving nursing care at home. The proposed research will accomplish the overarching goal of this project – to understand relationships between pain, frailty, and depression – by addressing the following specific aims:   1. Investigate a conceptual model of pain development among older adults in the community: (a) use latent growth modeling to examine whether frailty trajectories lead to incident persistent pain; and (b) evaluate the degree to which depression mediates the association between frailty and pain among older community-dwelling adults. 2. Evaluate the relationship between persistent pain and adverse health events: (a) assess the interaction of frailty and persistent pain in risks of falls and acute care hospitalizations; (b) describe behavioral changes associated with pain that may exacerbate frailty, such as poor nutrition, reduced mobility, medical use, and diminished social networks. 3. Characterize patterns of pain reporting and pain treatment among frail and non-frail older adults receiving home health nursing care.